Our longest-standing colleague in Bundibugyo now is Pat Abbott. She is due for a six-month Home Ministry Assignment (new mission-speak for furlough, or leave), and will travel with us next week. So Friday we planned a short tribute after team meeting, to thank her for her work and pray her on her way. All Christmas season we had been wanting to get in our annual viewing of “It’s a Wonderful Life”, but could not find the movie. So we had the great idea of filming a version for Pat. The great thing about being a team leader is one can have a great idea, and then dump it on someone else to sweat out the nitty gritty details, in this case Scott Ickes, who put in many hours of filming and editing! Julia starred as Pat, discouraged missionary ready to turn in her passport to our personnel director, played by Scott I. Jack co-starred as Clarence, the only “angel” in the missionary kid association who did not yet have his wings, earned by convincing a missionary to stay on the field. So Jack/Clarence takes Julia/Pat to see life as it would be in Bundibugyo if she had never come. There were scenes of hungry children (gamely acted by our neighbors, sucking in their stomachs and looking pitiful). There were scenes of irritable missionaries shutting their doors to requests (gamely played by irritable missionaries). There was a particularly great scene involving our neighbor playing a person that Pat has helped over the last year, in the scenario that there was not one around to help him. Another scene showed Luke and Acacia play Scott and me struggling with surly hearts through HIV clinic. In short Bundibugyo was depicted as a place just as bleak and desperate as the Pottersville of the original movie, a place where Pat’s merciful heart had not had its impact. The shocked Pat begs to go back, and the relieved angel prays, and suddenly the accountants at the sending center find her support account overflowing . . . And the movie ended with the whole team singing special Pat words to auld lang syne.
This skit was particularly apt because that very day we received a threatening letter accusing two of our missionaries of ruining the life of a student . . . Basically this kid was sponsored all the way through school, largely through the generosity of a young woman who worked here for a year many years ago now. As she tried to decide whether to fulfill his request for university sponsorship she asked for help from Pat, and some gave the opinion that the boy’s requests and plans were not reasonable. We thought she sent had sent the young man the money directly anyway, and since we had not heard from him in months, we assumed he was in school. Suddenly we received this complaint of “human rights abuses” and threats that if he commits suicide it will be our fault. . . . Not a typical interaction, but still very frustrating since he and his family have been closely tied to the mission and church over many years.
So a night to laugh together, to tell Pat that we would not be the same team without her, to remind her of the many many many people whose lives have been changed by her mercy, such a night was much needed.
I meet with the health center staff every Friday morning, alternating Bible study with continuing medical education. This week I began some basics of neonatal resuscitation in anticipation of a short seminar we will have on Tuesday, led by a visiting WHM board member who is a physician, Dr. Randy Bond. As we talked about traditional practices, we tried to put them in three categories: those customs that are beneficial, those that are neutral, and those that are harmful. Since about 70% of babies are born at home, it is important for midwives and medical personnel to be in touch with home-based practices.
In the beneficial category for Bundibugyo we definitely have breast feeding—most babies are handed directly over to the mother for skin to skin contact, initiate breast feeding in the first few hours, and keep it up for two years! Bundibugyo could teach the rest of the world a thing or two about this. There is no shame to an exposed breast, no setting in which feeding is inappropriate. And with encouragement a good number of grand-mothers (ladies my age!) have actually managed to re-lactate when caring for a grandchild after the death of the mother. This we celebrate.
In the neutral category we have the disposal of the placenta. The placenta is taken by relatives and hung from a tree. It should not be buried or disposed of. If it dries slowly on the tree the child will thrive. If wild dogs come and eat it the baby is given a special name and it’s survival is in question. On the scale of all that happens in life here . . . Hanging the placenta from a tree seems fairly benign, not hurting anyone. So we leave that alone.
In the harmful category, treatment of the umbilical cord. It has been common in times recently past to put animal dung or mud on the baby’s umbilical cord stump. This, as you might imagine, is basically rubbing dirt into an open wound, not a good idea. Thankfully the health workers have mostly convinced the public that this is not in their best interests. The eradication of the application of harmful herbs to the eyes is almost gone, too. One of the practices that angers me the most is the crude cutting out of baby teeth as a cure for diarrhea—this tradition we researched and found it only extends back about 30 to 40 years, having been introduced in the time of Idi Amin by his military, many of whom came from northern Ugandan tribes. This we fight against.
It strikes me that the heart behind most of these practices is good: parents want their children to survive, and are willing to be inconvenienced or pay fees or carry a placenta home, in order to ensure that that happens. I try to remember that when I see those who come to the hospital as a last resort after trying something in the third category. My judgmental heart wants to condemn them, but then I’ll see a mother crying and realize that she was pressured into the action by others, or she really believed she was doing the right thing. And I wonder how an outside observer would categorize some of the things I do? Pray for us as missionaries, to discern harm and fight against evil, while still having compassion on the people who do harmful things.
Kyomanywa is dwindling, ebbing away before our eyes. For the first six months of his life he seemed to be thriving in spite of being born to an HIV positive mother. His mother’s infection was diagnosed through the Kwejuna project’s antenatal care. As she began coming to clinic we encouraged her to practice exclusive breast feeding (no other foods or milk), and then wean at six months of age when his antibody test was negative and he seemed to be healthy (the national policy). Each month of breast feeding carries some small risk of transmission. His mother followed our advice and took the hard step of denying him her breast, very counter-cultural in a less-than-two-year-old. And then his weight started to drop. We boosted up his nutrition thinking this was a side effect of weaning. But every month she would come back worried about his health, persistent in her instinct that something was wrong. So I repeated the test for HIV—it was positive. He must have been infected just before he weaned. We must have waited a week or more too long? With his constant fevers and weight loss he soon qualified to start anti-retroviral drugs. At least, I thought, we can turn him around now that we know what is wrong. But he keeps slipping. It has been a month and now he’s worse than ever, with a terrible whole-body rash, itching, dark patches with raised borders. Today he sat scratching, his mom able to distract him into smiles a few times, but mostly he cried.
And I want to weep too. I stopped two medicines that might be giving him an allergic reaction. We have almost no options for altering his treatment course, so are persisting with two drugs instead of three for HIV. I’m checking some pitifully inadequate labs and a chest xray—could we have missed a co-infection with TB? Kyomanywa dwindles and waits for us to figure it out, his spunky mother who loves him and keeps telling me that we don’t have it right yet, and me his doctor who feels like there should be someone else to turn to and ask for the right answer. There are plenty of happy stories in my ARV clinic, kids who turn out to not be infected, kids who are so much improved on medicines that their mothers are frantically chasing them down. But Kyomanywa isn’t one of them, and as I am leaving for a month I can only pray he doesn’t dwindle all the way out of this world.
We have welcomed 2007 in style, Ugandan style. Last night the team gathered at the Pierce home with a handful of Christ School teachers, a few young friends like Ndyezika, and the ever-lively Bihwa family, a party unto themselves. There was food and a campfire and singing and drumming and dancing. Ndyezika and I almost fell on the ground laughing as Scott Ickes and Josh Dickenson followed Bihwa’s energetic Muleddu dancing with a dance of their own around the fire that they made up to commemorate Bundibugyo life with moves symbolizing hoeing, carrying water, greeting friends in the market, and riding a picky-picky. At midnight we hooped and hollered and beat drums and then dispersed to beds, to rest up for an even bigger party today.
Ten years ago, we spent New Year’s Day 1997 with Jonah and his family. He and his wife Melen had just moved onto property that we had leant him money to buy, a small mud house with a tin roof nestled up against a steep hillside farm that was just beginning to be profitable. We had worked together for several years by then and become friends. That New Year’s Day stands out in our memories: we spent the entire day out at his homestead, just sitting and talking and cooking together, unhurried fellowship. It stands out because about six months later the ADF rebels invaded. Jonah and Melen fled from that home, we scattered. It was later burnt by the rebels, and Jonah lost much. Bullet holes are still visible in the repaired walls. As he said today, during those dark days of 1997 we could not have known that ten years later we’d be back, at peace, still working together, still great friends. The decade has added four more children between us, seen Jonah through medical school, internship, and the rocky return to Bundibugyo, seen us through further MPH studies, team expansion, many ministries and projects. So it was with a great sense of thankfulness and joy that we decided to commemorate the Ebeneezer of the decade completed by celebrating the day together again.
Jonah asked us to come up in the morning and spend the day, and that we did. We dragged Scott Ickes along at the last minute (the kids’ pulled him in when he came up to ask a question). We sat on mats in the shade teaching kids to play UNO. We toured around the farm, seeing stands of matoke and cassava, cocoa and groundnuts and beans, scattering chickens, huffing up to the boundary mango tree to look back down on the valley. Jonah the doctor is at heart Jonah the farmer, with plans for more livestock and different patches of crops. Julia got smiles from the Jonah daughters (he has five now!) playing jump rope and tossing a ball. But the highlights of the day were two.
First, the goat. The whole idea was for Jonah to slaughter a goat for us, a way of saying thanks, of acknowledging us as part of his life. He chose a young kid from the very line that he has maintained since he was in primary school. Scotticus and our kids were fascinated by the whole process, and Scott (Myhre) used the dissection to teach lots of anatomy as the animal was skinned and then opened and cut up. The goat was all-day entertainment. Scotticus even helped chop some of it up into cook-able pieces. We ate the first part fried as a “lunch snack” and the rest stewed for the main meal. From bloody carcass to steaming dinner our kids thought it was fascinating and tasty. I marvel at the way God uses sacrifice and the meal of fellowship to symbolize His coming to us. Seeing it happen today made that very real.
The second highlight was taking Jonah and his older three girls to Ngite Falls in the late morning, after we had been hanging out together for a couple of hours. Though this home is less than a kilometer away from the Falls. . . He had never climbed up there! I got one of the girls to get in the water with me and let the spray hit her head, which is an intimidating experience for anyone, especially marginal swimmers. Jonah marveled at the spectacular beauty, and thanked us for being the ones that bring new experiences and adventure into his kids’ lives.
So today was another gift. The losses of the last decade have been significant. Jonah’s father was killed by rebels in the late 90’s; mine died this past year of ALS. There were many points of uncertainty, and as Sam says in the Lord of the Rings, many opportunities to turn back, only we didn’t, which is the bulk of what makes the story. Living out our relationship with each other through the changes, experiencing God’s mercy together over the long haul. We laughed a little about our plans to do this again in 2017 . . .
Being guilty is very uncomfortable I’ve been reminded. Especially as a missionary, hurting a person to whom we should be ministering. I suppose it happens constantly, there is just rarely anyone able to come and confront.
This morning a young man (who is now probably about 30) whom we employed many years ago came to weep in our kitubbi. Since we let him go, he had tried his hand in several businesses (with our help) and agriculture (with our help). But he has been unable to manage his family and finances the way he hoped without a steady mission job, and so had high hopes of being employed by one of the influx of new foreigners this year. When that did not happen, he concluded that we were to blame. One of the people who declined to hire him gave him a very blunt assessment of his problem of dependency, which he interpreted as coming straight from my mouth. After more than a decade of relationship this hurt his feelings terribly.
The truth is, he stopped working for us when everyone scattered after the ADF invaded. But the truth also is that we did not rehire him when he reappeared much later, rather relieved to not have a “high maintenance” person in the middle of our family and life 6 days a week, and glad for the opportunity to have pared down the number of people around our house. And the truth is that we have not encouraged others to hire him, more concerned to “protect” our colleagues from someone with a lot of problems (who got passed on to us by people who preceded us), instead of being concerned about this man as a human being who can learn and change and grow and get a second chance.
So I was uncomfortable coming face to face with the dehumanizing impact of labeling a person and passing that label on, then having it come back to bite me unexpectedly. After he poured out his anger and disappointment to Scott in the morning, I went on my bike winding through footpaths until I reached his neat little compound. We sat on a bench in front of the house, leaning against the earthen wall and watching children play in the swept dust. Part of God’s mercy to reveal my heart, to remind me that the person who asks for help too many times is still a person. Some days one longs for a washing machine who does not have four children and a pregnant wife and a sick father, or for a vacuum cleaner that does not want to borrow money so it can sleep under a leakless roof.
We entertained our neighbors last night, the third night in the last week we’ve had neighbors or friends over for Christmas, part of the fun and the challenge of living out the holidays here. In spite of many years of this, cross-cultural entertaining remains more challenging than the comfortable camaraderie of team mates, the uncertainty in the little things. For some we introduce elements of our own culture (mashed potatoes instead of matoke); for others we sense it is more loving to stick with theirs. Last night I knelt in front of our guests pouring water from a pitcher over their outstretched hands for washing, letting it drip into a basin, the normal way of hand-washing before eating here, in spite of the fact that we have a sink in the kitchen. Most of their conversation centered on our Christmas tree: not the ornaments so much as the fact that I had draped a beautiful local kikoya cloth around the bottom to conceal the bucket that held it up. Yes, Jennifer even dresses trees they shook their heads in wonder, finding my eccentricity entertaining. These neighbors have been part of our lives since we moved here. John Mukiddi is aging, suffering from hypertension and heart failure and arthritis. We live about 30 yards apart but Scott drove our truck to pick him up since he could not walk that far with his hobble and crutch and breathlessness. He’s a patriarch of the community in many ways, respected but moving to the sidelines, his sons gaining prominence. The picture is not all good. One son has taken a path that brings his father (and us) grief, the path of the “big man” here, where education and power lead to drinking, abuse, broken marriage. The second just moved back home after leaving the rebel movement that plagued us for so many years, a bright and ambitious young man who also sought success in the wrong places, yet now speaks of peace and forgiveness as he takes advantage of the amnesty. This is Africa where yesterday’s enemies can be reconciled. His charming young daughter thanked me for the food and played basketball with our kids, a reminder that the vague “rebel” menace has a human dimension. A third son is one of the students we sponsor, Luke’s age-mate and Caleb’s classmate now. He used to toddle around the mango tree playing trucks in the sand with our boys; now he’s a muscular teenager out kicking the soccer ball with them. We pray that he will have the grace to take a different path than his brothers through life. John and his older wife Yodesi remind me of my parents in some ways: their names are the African equivalents which is part of God’s sense of humor, their ages similar, their generosity, and their loyalty to me a small reflection of my parents’. I’m grateful for that, and dread the grief of their mortality.
In spite of seeing the growing frailty of my neighbors, age is a good thing in Africa. The holidays are actually called “bhilo bhikulu”, days of importance. But the root of the word for high or important or honored is “old”. What a contrast to our American culture of youth.
Names are NOT an important thing in Africa. This morning I admitted Simeo, a four-year-old with dayglo yellow eyes, a protuberant belly, and sticky limbs. He was brought by his paternal grandmother: it seems that her son (the child’s father) joined the army, so the child’s mother remarried. After a couple of years her new husband must have told her to return the other man’s child to his family, so the mother one month ago appeared at this grandmother’s house and dropped off Simeo. The grandmother knew nothing of his past history but as he became more and more jaundiced and ill she decided to bring him to my home today, and we brought him to the hospital. As I wrote up an admission paper I asked her his name. She looked flustered. She had no idea. I wanted to ask him his name but he was not speaking to me, in terror. So in her bag we finally found a little blue immunization card that had “Simeo” written on it. So Simeo it is. Diagnosis pending—could be sickle cell, or AIDS, or TB, or chronic hepatitis. I can barely imagine being 4, abandoned by both parents, and hospitalized in the care of a grandmother/stranger who does not know my name.
Lastly, a glimpse of HOPE. Hope is the name of a new ward in Kampala’s best hospital. An Irish missionary who survived the turbulent 80’s in Uganda then survived cancer back at home (he’s written his story in the book The Man with the Key Is Not Here) decided to come back to Uganda and start a high quality hospital in the capital city. The International Hospital is where Caleb had his appendectomy and Julia her broken arm set under anesthesia. This month we were there to get some immunizations for the kids and I noticed publicity for the new “Hope Ward”, an effort to get local business to sponsor care for the poorest patients. Yesterday I finally got through to the doctor in charge and received permission to transfer Asimati, an 8 year old girl who came with a limp but turned out to be twisted in pain from a grossly enlarged kidney. Praying she will receive expert care and surgery possibly from a urologist. The possibility gives me hope!
Rather disconnected thoughts today, but that’s how we’re spending our Christmas week. Boys pounding the soccer ball in the yard with our kids, reading the books they got for Christmas, seeing patients, spending time with neighbors, trying to advocate for the needy where we can, trying to enjoy our little place in the world and the Kingdom here in Bundibugyo.
This year we have meditated on the signs of Christmas, particularly the ones the angels gave: you will find him, wrapped in strips of cloth, lying in a manger. Here in Bundiubygo, clothes and meat are the Christmas essentials. Everyone we know has scraped together some spiffy clothes and some money for meat to celebrate the biggest holiday of the year. Bloody carcasses of cows hung in the market yesterday or lay on banana leaves by the roadside for hacking off purchasable chunks. The tailors have been working around the clock, stitching kitengis into creative outfits. And I’ve been right in the middle of it—this year for the first time I had clothes made for our family too out of local fabric. I had always resisted the superficial emphasis on clothing . . . But this year I just wanted to participate. And though money for meat is not a big worry for me, the energy, plans, effort that have to go into gathering ingredients and assembling every holiday treat for the family and team from scratch has been a challenge.
Into this frenzy and effort Jesus comes naked, wrapped in strips of cloth. Into this hunger Jesus comes lying in a feed box, his body our food.
We are grateful to be here, caroling in the dusk around our neighbors’ dusty compounds, exchanging the Christmas greeting “Webale Kwiko” (thanks for making it) with people who are never quite sure they’ll survive to another year, taking small gifts of food to the elderly men and women whose homes abut ours and enjoying their happiness, reading the Luke story by candlelight right down in the mucky manger of our real cow, taking communion in the Christmas church service with people whom we’ve known and loved for more than a decade. But this year I miss my family, too, perhaps knowing they are having Christmas without my Dad for the first time, perhaps being more and more in the role of “mom” for a younger team. So as I bustle through the holiday I need to be reminded as well: Jesus is real, and here with us.
Praying that our hearts and yours grasp the essentials this Christmas, the One whose coming meets all our needs, the One who wraps His life around us, who sustains us with His nourishing self.
It’s snowing on the equator—on the Rwenzori peaks, and down here in the tropical stew of our house, where about a hundred snow-flakes dangle on fishing line from the ceiling. If you’re Norwegian, living in Africa is no impediment to a traditional white dinner complete with lefsa and rice pudding and Scandinavian almond cookies. Our team of 27 celebrated together tonight, by candlelight, feasting, reading lessons and listening to carols. The men had formed a seasonal choral group to lead us in worship. Michael put together a series of songs and scriptures and meditations taking in the sweep of creation, incarnation, and heavenly glory. And we ended the night with a dance party: from the Elf Boogie to Joy to the World in a rap beat, exuberant dancing together, a foretaste of the REAL PARTY to come. If you haven’t danced to Christmas carols with Jack (who dances like someone who is growing up in Africa) or Gaby (who wears a ballet leotard to get in the mood), then you haven’t danced.
It isn’t all fun and games, there are still needy people all around us, friends we care about and strangers we pity. There is still the reality of desperation from those scraping together their money for clothes and meat on Christmas. There is still the fact that it takes a lot of work to plan and bake and clean and celebrate with no conveniences, stores, washing machines, vacuum cleaners.
But for a night the community of fellowship, the looking towards Heaven, lifted us out of all the muck of Bundibugyo. For that we are grateful.
If Jesus threw a Birthday Party for himself, I’m sure he’d have it in the AIDS clinic of Nyahuka Health Center. Pat with help from the team managed to transform the clinic today with some colorful folding foil decorations and a Christmas cloth, cokes, music, cinnamon rolls and muffins. There was something surreal about scrutinizing rashes and palpating spleens while carols blared from her boom box. Jesus says that if you want to visit or feed or clothe Him, then look for the Least of These. Pray for our team to remember that as desperate people and illness do not take a holiday. Maria’s orphaned infant Nightie was re-admitted yesterday on death’s doorstep, ashen and limp with dehydration. But today she’s revived on therapy. I am often reminded of the title of a good friends’ book (Maria Garriott) about ministry in the inner city: A Thousand Resurrections. Nightie, for one. Rascally active toddlers gaining the energy and bulk of ARV’s. Today Scott called me into the ultrasound room to witness the discovery of triplets in a bulging abdomen. The mom gasped at the news, but was happy. The last set to be born around here came yesterday for check-ups, all thriving at 2.9 kg (which means they’ve each nearly tripled!!). Little victories, repeated resurrections, glimpses of hope.
Christmas, the Bible’s Christmas, is not a mellow story. Simeon warns the new parents: this child will be spoken against, his destiny will be for the rise but also the fall of many, a sword will pierce your own soul. Soon innocent babies perish in a full-scale slaughter and the behind-the-scenes battle is seen in Revelation 12. Christmas is a story of conflict. When Infinity Incarnates, evil reacts with wrath. The fleshing out of God’s presence disturbs the forces of the universe.
Somehow today’s party enfolds epic conflict with baked goods and songs. Babies’ lives are at stake. The people of the Kingdom are struggling to save them. It’s a lot of work to listen to and consider and prescribe wisely for 71 patients, let alone to make sure they all get a treat and a coke. Most won’t see the reality of what is happening but just be satisfied with sweets, but we know that somehow Christmas makes it all fit together, the resurrected hopes of one family and the ultimate freedom from death’s destructive power. Amen.
Kabasunguzi went home. Well, not to the only real home she can have, which I am painfully aware is Heaven. But today I took her from the hospital so that she and her mother could spend Christmas with her nearby uncle. She has been hospitalized since July. My best guess on her diagnosis is cerebral schistosomiasis, a parasite from the lake area where she used to live in the northern part of our district, a rare complication. She came to us devastated, wasted, in pain, barely alive, 12 years old and about 25 pounds. When she developed convulsions in spite of treatment we sent her for a stay at a Christian neurosurgical hospital on the other side of the country (funded by a supporter). They sent her to the national referral hospital in the capital where she languished for over a month, being seen by a doctor only a handful of times in those weeks. When her mother pleaded with us that they were both going to die there, we brought her back. She had failing vision when she left, she returned completely blind, paralyzed, with spastic contractures of her left arm and a pressure sore from being bedridden and malnourished. Over the last few months with wound care and good nutrition we’ve managed to heal her skin and put about ten pounds on her frame. Her neurologic deterioration seems to have stabilized at least. Today we carried her to the car and drove her over the bumpy road, wincing, to a small earth-colored house surrounded by cocoa trees.
The dancing? Not much. Her mother has become a competent nurse, caring well for her daughter, thankful, hopeful. A couple of weeks ago I bought Kabu a cassette player/radio for her birthday, hoping to provide some auditory stimulation in her dark world. Her mom danced then with happiness.
The mourning? Today when it was time to decide to go, I asked Kabasunguzi if she wanted to leave. No, she replied. Why not? I was surprised. She held my hand and explained that she was not yet healed. My heart just broke, I had to go and cry. This frail little blind girl confined to her bed, still hoping to see and walk.
I wish for a miracle, for blind Kabusunguzi to see the purple cocoa and green/grey leaves outside her window, for this lame girl to get up and dance right here on this dusty planet. Jesus announced his Kingdom would be full of this kind of celebration—I want to be there to see it happen. Did we really do her any favors by helping her remain earth-bound this long half-year? The veil obscures Heavenly reality today, and we grope forward by faith.
