Paradoxically, home

Coming home is a paradox in and of itself.  My heart is here, but my soul also feels the heaviness of this place.  In fact, as we packed up camp with the interns and prepared to drive back, we later found out that the rest of the team narrowly decided against a full-scale revolt in bagging their return from the Kingfisher (where they stayed while we camped) and extending the heavenly weekend by another day!  I understand that sense of unease, the lingering feeling that just one more day in the little paradise of flowers and order and escarpment breezes carved out by a German missionary would fortify the spirit for re-entering the miasma of Bundibugyo.

But in the end we all returned, the draw of home and the dread of facing problems again all jumbled together as we bounced over the rocky, rutted road.  And the return was both grueling and joyful.  Grueling in the physical and emotional toll (see below).  And unexpectedly joyful, because of Julia and Jack.  They get car sick and we were so crowded that we let them ride on the top of our crazy load of camping gear (tents, cooking equipment, clothes, etc for ten), groceries, cow feed and mosquito nets for HIV-infected families on the back of the truck.  And they decided to wave greetings to anyone along the road, smiling, getting them to wave back.  In Bundibugyo there are A LOT of people along the road.  So instead of “mujungu mujungu” cat-calls or obnoxious curiosity, we entered the district being smiled at and waved to by several hundred people.  They were of course responding to the kids, but from the front seat of the truck we could imagine that the grandmothers shifting loads of firewood to greet, or the dancing children coming home from their gardens, had specifically waited just to welcome us.  It was very pleasant, the sense of being drawn in and celebrated mitigating the anticipation of the problems we would soon face.

This is the place of paradox, moon-washed mountain views seen from the valley of shadow, culture-crossing friendships tainted by misunderstanding, children plumping up on treatment while others gasp their last breaths.  This time was no different, we were once again awash, as we knew we would be, with abundant views of creation splendor and crushing realization of the desperation of the Fall.  Scott struggled all day with the bike of Jack’s that I ran over before I left—unfixable it seems, until we can get new parts, plus the broken toilet and the broken lawnmower, the obscure Ugandan bank statements and the neediness of people who had missed his help for a week.  I plunged back into the health center where the third patient on rounds died right before our eyes, a little twin whom we had cared for with moderate malnutrition and probably sickle cell anemia, who needed a blood type that was not available and whose heart could not sustain him until the proper blood could be found.  Nine patients have died in just over a week, including three transferred from the district hospital with end-stage severe malnutrition who did not even survive one day of treatment.  In spite of all that, it is a relief to be home, to be together after all that edgy anxiety last week, to listen to a dust-dampening sprinkle on my own roof, to sit around our own table in candlelight and laugh.  Paradoxically, we are pilgrims and strangers who have the sense of coming home.

Job's Journey

Mid-summer, we take our interns to the game park.  This is a weekend for them to get away from Bundibugyo, to get perspective on what God is teaching them, to avert their eyes for a few days from the relentless suffering of Africa and be awash it the continent’s beauty.  When Job’s friends exhausted themselves trying to explain his problems in a cause-and-effect obedience-and-blessing universe, God finally steps in (chapters 38 to the end) and basically takes Job on a safari.   Can you hunt prey for the lion?  Can you mark when the deer gives birth?  Did you set the wild donkey free?  Will the wild ox be willing to serve you? Does the hawk fly by your wisdom?

As an answer to Job’s distress,  God’s tour of the wild wonders of His creation seems to point to His power, His beauty, His creativity, His being GOD.

But this weekend, I saw another side to this lesson.  Over and over God takes Job on a journey of the animals and nature to point out:  Job can not control them.  Nature is unpredictable, untamable.  Camping in the wilderness we experience this first hand.   We drove through the park with our interns piled on top of our truck. At some points we were awestruck by the splendor:  in the pre-dawn darkness, a majestically powerful leopard stretching his night-weary limbs, slowly rising, regarding us interlopers and then sauntering off into the bush.  Restless elephants trumpeting, semi-playfully pushing each other in slow-motion splendor with their ponderous strength.  The flash of jeweled orange as a tiny malachite kingfisher flits up from the reeds.  But at other points we drove and drove and drove, watchful, not seeing anything.  A large grey male lion trotted away after barely a glimpse in the distance, lying down concealed in inaccessible bushes, tantalizing but unreachable.  There was nothing we could do to make animals appear where we wanted, or wait for us to see them well.  They are, after all, wild. This is a savannah, not Disney World.  The experience is not humanly orchestrated.  Sometimes we will be disappointed.

Driving home today, I began to think this was the real point God was making with Job.  Yes, nature shows how creative He is.  But what He was trying to point out, is that nature shows how wild He is.  How Other.  How beyond being orchestrated by human desires and ideas.  We want formulas that work, like Job’s friends we want to put our good intentions in and see God’s abundant blessings flow out, measure for measure.  But God tells Job, look around.  You can’t tell the wild donkey where to go, nor can you control the details of your own life.  God is God.  He does not show up on our schedule.  His actions may not correspond to what we would want.

Like Job, we need to be pushed to break out of the mold of a God-in-our-image, a God who acts as we would, who does whatever we plan.  The inexplicable suffering of Bundibugyo and the untamable beauty of the African plain both shake us out of our illusion that we can predict, let alone dictate, God’s actions.  Like the leopard we saw this morning, He defines Himself on His own terms:
I will be gracious to whom I will be gracious, and I will have compassion on whom I will have compassion.  (Ex 33:19)

Driving the Ledge

Well, today I’ll be literally driving along a ledge, the spectacular mountain road that leads out of Bundibugyo.  The kids and team and I are heading out, we will all meet up with our Sudan returnees at a small lodge on the edge of the national park about five hours away, for a long weekend together.  Last night when I was struggling to load the car with trunks and camping equipment, and we heard hissing air from a tire, so I was rushing to get it parked on cement to make changing a tire easier and ran over a bike left on the ground . . .Jack’s, which he uses to avoid walking on his heels . . .well, it was a low point, being eaten by evening insects with a half packed truck, a broken bike, and what I thought was a flat tire, in a day in which four patients (!!) had died.  In short, I keep thinking about the edge, and the path was seeming rather narrow.  But Caleb says the bike is probably fixable, we tightened the cap on the tube of the tire (it would have been the fourth flat this week) and as of this morning it is holding, the kids got the tarp over the mountain of stuff and after prayers and dinner we were all more calm.  Pray for us to rest, in the wild wonder of God’s creation as we visit the park, to get a bigger picture than our daily struggles.  
PS Check out the Macha’s blog:  Nancy’s tumor has shrunk, so that is encouraging news!  

The thing about edges . . .

. . . Is that while standing on them, one is perfectly safe, but the perceived drop to disaster is very real.

Which may be why God likes to take our path along the ledge.

For instance, yesterday morning the UPDF began a training exercise that involved intermittent large artillery which we could hear in the distance.  The main barracks is about 15 km by road from us, though with mountains reflecting sound and our house being on a rise it sounds closer.  This practice is good, in reality, part of that solid rock where we now stand, protected.  But it started literally one minute after I hung up the phone with Scott who was from that moment on unreachable, en route to Sudan.  And in the early morning, the sonic booms of distant guns were for me a peek over the precipice, a gut-tightening recall of times now long past when we did not have a prepared military and when rebels could make forays across the border at will.  I am not falling, I’m standing on the path.  But the view into the Fall is dizzying.  

This is similar to the case of the little boy who died last week, whose blood and tissue samples are now being processed by the CDC.  The real danger of this being a viral hemorrhagic fever is almost nil; follow-up in his village has assured us that no one else is sick.  Again, we are standing securely, but the events of the last year make the view over the edge steeper and more frightening than it would have been.

So it is no surprise, in this context, that just after daylight this morning there was yelling, running, commotion and cries a few houses up the road from me . . . No, no rebels, no real danger, just a goat thief.  By the time I got there most people were laughing, perhaps to cover their anxiety.  The goat had been recovered but the thief got away.  

And though I am distressed by the slowness of UNICEF to get milk to our malnourished kids (18 of 29 inpatients now with severe acute malnutrition, little signposts of no rain and rising food prices), when I plead on the phone I’m looking over the edge and feeling faint, instead of noticing that we do still have enough for another two weeks, and kind supporters who I know will rise to the occasion if nothing happens by then.

A wise friend asked me last night to reflect on the timing.  When I am here alone, my sense of the edge is more menacing, my reserve more strained.  But this is the time to look at the path instead of the drop-off, and be thankful for the Rock on which I stand.  Not easy.

Edgy

Scott and Luke headed out under the crescent of a waning dawn-tinged moon this morning for Kampala with Kim, Nick, Jesse, Katie and Michael.  Unfortunately, they had to go in a vehicle with the hood held on by a bungee cord and hourly bolt-tightening checks to make sure one of the loose wheels does not fall off.  That’s because this vehicle is MORE reliable than the one that nearly subverted my trip last week:  after much work, Michael and Scott prepared it for a test run last night, but it overheated without ever leaving our driveway.  And that’s because they had to leave me the MOST reliable of the three, our truck, which had three flat tires within the last 24 hours but still beats out the other choices.

The group is heading to Mundri, Sudan, where the Massos hope to establish a WHM team presence by the end of this year.  And the unsettled, edgy feeling I have today reminds me of that the team will not just materialize, there is cost involved. All three Masso children are moderately ill, not a great way to be left with a single parent, one with the first really significant asthma attack of her life.  As soon as they pulled out Jack, who had had a better weekend, began to spiral downward, and only went to school by faith, pocketing a verse from Psalm 23 to read and memorize when he felt the waves of sadness coming.  CSB was attacked by theft on Friday, someone breaking two padlocked doors and getting into a safe, someone who was incredibly lucky and brave or who knew just what they were doing.  So a school already in debt, already struggling, now losing another couple of thousand dollars. Our RDC is mobilizing people to awareness in case the anti-LRA increased pressure by MONUC in Congo sends any rebels our way (no real threat, just being cautious, but not the kind of thing one wants to hear).  Some of the UNICEF milk is now expired and patients showed me maggots in their packages today, just as the nurses I sent for training to Mulago called to say that in spite of my visit and verbal affirmations from Kampala that it would be fine, now that they are there the Mulago staff are expecting to be paid “something” to allow these two nurses, their own Ministry of Health colleagues, to observe and learn.  Aren’t we all trying to help starving children here?  Just to remind us of that reality, the latest admission, a 15 month old boy, severe malnutrition (6 kg--of which a fair amount is edema) Owera came in with his burning fever, listless gaze, scabby skin.   His father died with AIDS last year, and his mother finally gave up on the meager slow help she was getting elsewhere and came to Nyahuka to try and save his life.  And I hope hers, while we’re at it.  My patience wears thin and I was not so pleasant to two men asking for money and medicine, stopping me in the hot sun as I huff back home on my bike.  I feel overwhelmed already, and my guys have only been gone six hours.  In short, it is a morning that screams, “the world is not right”.  

But we head out on a wobbly wheel, believing that the Kingdom is still coming.  Needing prayer for our hearts mostly:  that hours and days of boxing with the devil, of pleading phone calls, of sympathetic listening, of weary prayers, of plain old sweaty gritting it out, will see the results.  That the cost will not prove more dear than the beauty to be revealed, in Nyahuka, in Mundri, in us.

Shooting Dogs

In the midst of being tossed about  in the sea of life’s sorrows here (see post below) we do still have our dear interns, and one of the ways we generate awareness and discussion of African issues is to watch a few movies after team meeting on Thursday nights.  One of the best:  Shooting Dogs (2005), set during the first tragic days of the Rwandan genocide in April 1994.  This movie got little play or attention compared to Hotel Rwanda, but it is a hundred times better.  Grittily real but grappling with redemption, it follows the true story of 2,500 Tutsi and moderate Hutu refugees who sought protection from the UN in a Catholic school compound.  It was produced by BBC Films.  The frame story is of a British career missionary priest and a young teacher year-long volunteer.   This movie is not for the weak of heart:  the violence of genocide is not glossed over.  But it asks very clearly:  where is God in the midst of this tragedy?  How should missionaries, powerless citizens, or foreign soldiers respond to flagrant injustice?  

As painful as the movie is, I’ve watched it several times, and each time I find it profoundly moving.  Many reasons:   it is based on actual events that occurred only a few hundred miles from our home, while we were living here, and contains many scenes that are familiar, from the dusty roads and chattering children to the agonizing scenes of evacuation and survivor guilt.  And because many of the actors and producers are actual witnesses and survivors.  But mostly because it provides a modern-day picture of the Gospel.  The Christ-likeness of the priest would be remarkable even in a Christian film, let alone a BBC secular production.  I won’t give too much away, but in this viewing what really stuck with me was the final scene.  He is driving a truck full of hidden Tutsi children through the dark streets of Kigali and meets a road block manned by a former school contact whom he knows.  As the man with the gun accosts him, he says “The amazing thing, Julius, is that I feel nothing but love for you.”  The first time I saw this I found that line unbelievable and corny.  But since it is witnessed by a survivor, it is probably true.  This time I saw it with hope.  That in the most extreme moment, a person who has chosen a cross-path, can actually be supernaturally filled with enemy-love (hesed) even as Jesus was.  

Our trials here represent cup-sized empty pots in comparison to the life-and-death whole-scale societal implosion of 1994 Rwanda.  But if God was present in the midst of that suffering, surely He is able to meet us in ours.  Because in the end, the reason the priest stays is that he finds the desperation of the tragedy makes God more real than ever.   This is the longing of the songs of lament:  relief, yes, but more deeply to meet God in the sorrow.  

(NOTE: a comment under this post by an informed reader says that this movie was marketed in the USA under a different title: 

Beyond The Gates (2005)). 

The Party's Over

For a few days we rode the crest (Bdays, good decisions, hopeful connections, healed patients) but we’ve now been thrown back against the unyielding rocks of reality. Death.  Yesterday morning as Heidi was weighing patients before rounds, and I was evaluating a dehydrated baby an off-duty nurse had pulled me aside to see, a family burst into the ward with their semi-conscious 6 year old son.  He began to vomit a putrid blood-tinged bile, and pass foul bloody stool.  Within a minute we had cleared out the treatment room, gotten gloves and IV supplies, and Heidi and the other nurse began to work on IV access.  The family gave a story of a grandmother who had just died, then this boy became suddenly ill the day before with headache and fever, and even blood in his urine.  A year ago I would not have been as concerned, but post-Ebola our awareness of the nearness of disaster has been forever heightened.  And our staff acted quickly, carefully drawing lab work, preparing the isolation ward (which has been closed for months), treating the patient’s symptoms.  When the malaria smear, sickle cell test, and other labs all came back negative we knew that the sudden onset and hemorrhagic symptoms warranted reporting the case and sending samples.  Sadly the child died about an hour after he arrived.  So the rest of the morning we had edgy staff, tangles of phone calls, a loudly wailing mother, and the  sad task of decontamination and bagging this small body.  The chances that this case will turn out to be anything worrisome are very, very remote:  his age, his location far from the other cases in the past all suggest that we were merely seeing the agonal last hour of a more common disease.  But I found the whole process profoundly tiring, dredging up the memories of the uncertain days of last December.   I found out that Heidi is made of strong stuff, calm in crisis.  I found out that once I got people on the phone, the mention of “bleeding” and “died” and “Bundibugyo” in the same sentence gets action.  Within two hours a blood and skin sample were delivered to the district for forwarding by the surveillance officer to the lab at the Uganda Viral Research Institute in Entebbe.  Results will take a week.   Discouragment.  Our youngest is struggling.  He was sick more than a week ago with an impressive rash, and now feels profoundly tired and sad, sort of a post-viral blueness exacerbated by the you-don’t-belong nature of his stressful school life, the spiritually dangerous nature of this place, anticipated grief in changes in the family as Luke moves towards boarding school, and mostly by his own discouragement that his calcaneal apophysitis (the heel problem) has still not fully healed.  I am used to a clash of wills.  I am not used to a heart-wrenching helplessness of a sobbing child.   Depletion.  CSB has its daily draining needs, 99% of which fall upon the Pierces, but as their team leaders and friends we ache here too.  Income (student tuition) has NEVER (since the inception of the school) covered Expenses (primarily Teacher Salaries and Student Meals).  This gap has been growing and now looms menacingly. Then this week they analyzed the food allocation more closely, and realized that as the numbers of students had expanded over recent years the protein provided in the diet had not kept pace.  When David saw that they were getting less than 20 grams of protein a day (instead of a good adolescent minimum of 50) he doubled the purchasing of beans and ground nuts.  An appropriate move, but a move based on faith and not on money in the bank.  Many schools in Uganda have been hard hit by the escalating food prices, and a season of relative drought.  We are not exempted.  Almost every day there is another challenge, and the ever-present background of debt makes each one more difficult. Demands.  One of our team Bible study questions this week was : Where are you, and where does God want to take you?  I had an image of treading water.  There is an occasional crest of wave when prayers are answered, when vision clears, when the ride is exhilarating.  But mostly I’m down in the valleys between the waves, pumping and paddling to merely stay afloat.  Progress is elusive.  Every hour of every day brings another needy person or undone deed.  The demands of life in Bundibugyo are endless.  Taking the time to advocate in Kampala and to spend on a fun activity last week means that this week I feel even further behind than usual.   But this morning in Psalm 88 I read:  “You have afflicted me with all your waves”.  What if I’m not treading water, but I’m enveloped in the very substance of life that God has sent?  What if the answer to “where is God taking you” is a wilderness of water, a dragging expanse of death, discouragement, depletion and demands?  What if He has allowed this for good, because what I really need and want is Him?  A theme of our study:  all true worship begins in wilderness.  Not in spite of wilderness, but because of it, because we need the gasping clarity of the struggle to stay afloat in order to know God’s grace. The party seems to be over, but I have a thin lifeline of hope that it’s just beginning.

Happy Bday to Me: wild nerves but generally unshockable

My kids, with Miss Kim’s help, put together a sweet folding book of family pictures, then Pat surprised me with a bag of dark-chocolate-covered-expresso beans from Trader Joe’s when I went into the exam room to see my HIV positive patients.  I’m sure that was the best thing that ever happened in that sad room.  There was a note saying “you need Holy Spirit to meet to be a strength in weakness. .  . but a few espresso beans can help.”  It was my turn to be prayed for at our weekly prayer meeting too, and Scotticus burned me a CD of a new artist (we over 40s need help to not get too stodgy, though Luke’s card assured me I was “sparky” and Jack’s was also very encouraging). We had a quiet family dinner and enjoyed a cake Scott made.  He and Julia both wrote me poems!  I’ll share Julia’s below, since Scott’s is at least PG-13.

My mother is amazing
With four kids daily raising

She helps a starving child
Comes home with nerves wild

The cook of the best food,
In a much cheerier mood.

Bad cases does she doctor
But Maate has yet to shock her

She’s a beautiful crazy mother,
And I’d like no other.

Miracle of medicine, surgery, hope, and prayer

Maate is being healed, slowly but surely.  This is the 15 year old boy, Luke’s age and Liana’s size, who was suffering from severe abdominal pain and wasting thin-ness a couple of months ago.  We thought he must have TB but he did not improve on the medicines.  His patient perseverance really got to my heart, and when he began to deteriorate more rapidly we could not bear to watch him die.  The International Hospital of Kampala, founded by missionary Dr. Ian Clarke, has the best care in the country and one ward dedicated to providing free care for a limited number of desperate people.  Many people prayed for Maate and the Hope Ward of IHK agreed to admit him in late April.  

It turned out that he did have TB, but the TB was located in the linings of his intestines, making it difficult for him to absorb both food and the medicines that would save him.  Doctors at IHK inserted a feeding tube that bypassed the worst area, and allowed the drugs to begin to do their work.  We visited him twice in Kampala, as did other team mates, he looked so out of place on that shiny new ward, a lost soul in a big city.  But he did get better, slowly.  When he was discharged back to us a month ago his weight had crept up from 19 to 22 kg, but his pain was much less and his fevers gone.  Now after a month of nutritional rehab (thanks to UNICEF milk) he’s up to 27.4 kg today, and officially discharged.

He’ll have to complete months of daily anti-TB drug doses, but his returning muscle and ever-present smile are signs of hope.  He and his mother walked to see us from the Congo border today lugging a jack-fruit almost as big as Maate as a way to say thanks.  He’s planning to re-enroll in school next term.  I don’t know what plans God has for this boy, but the visible sign of “all things made new” is enough for me.  I heard staff commenting that he should be named Lazarus, one who was raised from the dead.  In the midst of many struggles and disappointments, seeing someone like Maate transform from a skeleton to a boy, is a miracle that keeps me going.

Golden Girl

Miss Ashley turned 23 on June 23rd, which makes this her golden birthday, a little slice of American culture I did not learn until my team mates here introduced it (your special Bday is the the one when the day and the age you are turning match . . ).

Perhaps appropriate that it should fall while she is here.  There is a haunting Edgar Allen Poe poem called El Dorado, where the knight is searching for the land of gold, and goes “over the mountains of the moon, into the valley of shadow, ride boldly ride, the shade replied, if you search for El Dorado!”  We are definitely over the Mountains of the Moon and deep into the valley of shadow here.  Interesting that this is where we find true gold, far from “home”, in a place of shadowy distress.  Ashley has been one nugget of that gold for us as she teaches the team kids and coaches the girls’ soccer team, or just hangs out with our family as a friend.  The Pierces planned a surprise pre-school breakfast party for her in the morning, and we joined in with the Massos and her housemates for an evening complete with special lava cakes (her mom sent a mix for her favorite dessert all the way to Africa . . .) and gifts.  And that is the real gold here, the community formed in the valley of shadow.