News on Tuesday

From the Associated Press:  KIBATI, Congo (AP) — A cholera outbreak in a sprawling refugee camp has spread to eastern Congo's provincial capital of Goma, increasing fears of an epidemic amid a tense standoff between troops and rebels.  We studied the cholera epidemic in this very area a decade ago, when we were at Hopkins for our MPH degrees.  Massive congestion and crowding as people flee from war, drinking from contaminated surface water, hard volcanic soil that makes it difficult to dig latrines, and surrounding political instability cutting off aid:  all of that adds up to unbridles spread of cholera.  We've seen cholera before, it is gruesome.  This is bad news.

From BBC Radio, we heard Nkunda himself interviewed this morning, confident, aggressive, projecting his rebellion to sweep the country and anticipating the aid of political allies.  The reporter later commented on the well-equipped and disciplined troops, estimating their numbers in the thousands.  Then a government spokesperson said he would next see Nkunda in jail.  The chances of peace sound very remote.  We are not affected, yet, but listening with concern.

But both of these issues, cholera and rebellion, represent a society gone wrong, and not far away.  I am reminded of the response of the early Christians:  come Lord Jesus, come.  And struck that as we turn to corner towards Advent, the anticipation of the coming of the Messiah, it is just such evidence of the world gone amok that makes us strain our eyes . . . .

Jack of All Trades

We cut out a great quote, a while back, about all the diverse things a human being should be able to do, from deliver a baby to sail a ship. Missionary life affords many opportunities for diversifying one's skill set: making marshmallows from scratch, for instance, or milking a cow. Or installing a solar hot water system. Scott and Nathan spent the entire day Saturday (?10 hours) assembling and installing a solar- heated water tank for our teachers' home. Threading pipes, dealing with coolants and gradients, digging pipelines, busting through shower walls. I'm sure it would have been easier for Michael, but now we're on our own. Scott, I know, often feels the pressure of "the buck stops here." If there is a plumbing issue or a computer crisis, a serious illness or a immobilized bike, it tends to find its way to him. And he's good at figuring things out. So there is satisfaction when hot water flows, and frustration when he can't make it work, and a need for prayer to maintain equanimity whatever the case.

Girls and Boys

For many years I believed that it was easier to be a missionary kid boy than a girl in Africa. Our yard was always populated by boys, who did not have to mind babies or carry water at home and were therefore more free to come and play. Boys are over-represented in schools, and more likely to speak English. Boys can build friendship on playing football and digging in the sand-pile, running and tussling. Julia always held her own with all this, but I anticipated life being more difficult for her.

However, I was wrong in many ways. We attended chapel at Christ School yesterday, which we do intermittently, an optional early morning Sunday service with greatly energetic praise and worship (OK, we are Ryan groupies and went to hear Skip preach again!). I noticed that there were a fairly equal number of boys and girls, about 50 of each. But those 50 girls are half the female student body, while the 50 boys are only about a quarter of the males. At one point they read a Psalm responsively. The girls' verses sounded as if they had practiced: in cadence, loud, assured. The boys' verses sounded mumbly and limp. The girls sit in a tight cluster. They boys sit scattered. Julia immediately went to a bench with friends and sat with them. Jack and Caleb stuck with us.

It has been one of the shocks of this year, that our daughter is much happier at school than any of our boys have been. Miss Ashley and football are a huge part of that. Julia's personality is another, she is friendly and open and generally cheerful, confident. But I think there is something deeper that we are glimpsing.

In a strongly patrilineal society, boys represent clan, ancestry, land, power. They are in subtle competition. Outsiders are dangerous. But girls are expendable and temporary members of families, they are traded off for marriages and have fewer rights. A girl is less threatening. So, subconsciously, our daughter finds more acceptance than our sons as a teenager (almost) in a rather closed community. She will face her own challenges; we live by faith when we hear the comments that men make about her as they do about any girl. But for now we are thankful for the unexpected gift of companionship she has found.

Soul Space

In today's early morning Bible study, Barbara shared her life story, with pictures.  It was a beautiful image of what missions should be:  a foreign woman entering into this rural African culture, but connecting on common themes of caring for siblings, growing up too soon, loss, the pain of bearing a disabled child . .  . and looking, finally, to God.  There were two university-educated teachers present, from CSB, women with dreams and ambitions that might be more similar to ours.  There were a couple of younger women, in their late teens and twenties, who are navigating the changing society.  There were a half-dozen mothers, who may not have much formal education at all, whose world revolves around hoeing in their garden and feeding their babies.  We all sat in a circle and listened, drawn into community by the common elements of Barbara's story, and by the interesting and humble group process of translation.  When she described, like Job, the responses that she received to the extreme physical and mental disabilities of their third child, the women nodded.  Evil spirits?  Lack of faith?  Unconfessed sin?  All of these are real, and all bring fear and blame and despair to a grieving mother.  She led us through Scriptures that grapple with the problem of evil in a very personal way, and show that many of the painful experiences of our lives result from living in a fallen world. I saw this morning the way that someone with a graduate degree, from a wealthy professional neighborhood in a distant country, could breach the gap:  through suffering.  Barbara ended with these words, of hope, promising more next week:

When God hurts you He creates a space in your soul, then He fills it with Himself.

Friday, finally

It has been a bit of a long week. This afternoon I am thankful to be
home, after a very long day at the hospital and rain of Biblical
proportions turning the road into a river. I stopped on the way back
to check up on our student Ivan .. . reality check, the entire
compound where he lives was under water. No wonder the ward is
crammed with babies with diarrhea, I shudder to think of what is
swirling in the muddy pools that cover most of the ground. Dr. Louis
reported for his first official day of duty, three months into his six
month contract. For a district which should be desperate for doctors,
our administration has made it incredibly difficult and tedious for
this man to move into the doctor's house . . . he actually brought his
three other doctor friends to team pizza last night, along with our
nutrition extensionist . . . perhaps we are using food to lure these
bright young men to stay, but if it works it's worth it. A mission
worker who has AIDS made a suicide attempt last night, taking a bottle
of anti-retroviral pills. The pressure of ostracism and anxiety weigh
heavily on infected people, particularly single women I'm afraid.
Meanwhile Scott led about 25 medical staff this morning in a review of
our prevention-of-mother-to-child transmission efforts, a good time to
ask ourselves why our health center's performance has slipped (a few
years ago we managed to test more than 99% of pregnant women, now it's
about 75%). He introduced the new T-shirts he designed, with the
Kwejuna Project logo (THANKS FRAN ALLEN, it is still serving us!) on
the front and a Crested Crane on the back with the message: One Life,
One Wife. That got a lot of reaction, joy from the women, and teasing
of polygamous staff, and some disgruntled sighs from the men. Will be
interesting to see who wears it!

So those are the external events of the day: rain and diarrhea and
sick babies and spinal taps, teaching and laughing and exhorting and
visiting, listening and messaging and planning and cooking.

Internally, the teaching from Skip continues to sink into our hearts:
honesty, humility, helplessness. Learning to live our real story,
unhidden, not a version which we wished were true. Learning our
limits as human beings in the hands of an unlimited God. A great
phrase: resigning as general manager of the universe. I am
personally processing how to be a competent doctor who strives for
accurate and effective diagnosis and treatment .. . while accepting
failure. How to be an agent of change in a fallen world . . .while
accepting the impossibility of changing much. How to be a responsible
team leader . . . who does not try to control my team mates' lives.
How to alleve the suffering of children, even my own . . . while
accepting that some suffering is an integral part of our cross-walk
path with Jesus. Which brings me back to Chesterton and the paradox:
not a compromise, but a grasping of two good extremes, a living out of
incarnational truths: competence and failure, work and rest,
responsibility and freedom, power and sacrifice, weakness and strength.

For Masso Fans

I had my first phone call from Mundri, Sudan, this morning. Michael
and Karen arrived with their umpteen hundred kilos of gear on a
chartered AIM-air flight. They unloaded the plane and carted the
goods from the airstrip into town (easier now that there is an actual
BRIDGE instead of the wild hand-over-hand boat passage we experienced
on our visit . . .). They assembled the kids' bikes and all was
going well except for one small detail. The man with the key was
gone. They rented a small house to accommodate them while they build
their own place on land the church has donated. But the house was
locked up and no one quite knew how to locate the key. When I talked
to them they were preparing to sleep in a tent for the night, and had
stored all their gear in a tukul (local hut). So begins the newest
WHM Africa team, a few hours into their official move to Sudan, and
already homeless! But they sounded great, being Africa-veterans they
were not to worried, and it was amazing to realize that in spite of
the remoteness of both of our locations we can talk to each other.

God's Humor?

Does God have a sense of humor? Tonight the Ryans had a lovely dinner
with us, after a very long day, we were able to finally relax and eat
a great meal and hear a bit more of their story. We still have the
sense of unreality, that these people who are so important could be
sitting in OUR house in Bundibugyo. Anyway after dinner, tea,
conversation, fellowship, with the theme turning to us, to avoiding
burn-out, to setting boundaries, to the kind of things that
spiritually sensitive and directive people in our lives need to say.
Scott talked a bit about the long day the day before, and the
frustration of coming home late to find yet one more person with an
ear-ache waiting in the yard for care and his irritation with the
person. I talked about saying no, how hard it is, how this very day I
told a Christ School girl who walked into the ward to see me that
she'd have to come back tomorrow because I was overwhelmed with other
patients, only to come home late and find a message that she was worse
and in a lot of pain. But in both cases we did sense a limit, a human
inability to rescue, a need to say sorry but we can't manage
today . . . We talked about our kids and our team and the things going
on in life in general, until about 10:30, all of us were tired, they
graciously bowed out, and we prepared to quickly clean up and get some
rest.

Ha. Not five minutes after our whole conversation on setting limits,
a neighbor from up the road appeared in the darkness as our dog went
wild with barking. There in our driveway was a scene from the Rwandan
genocide, a young man swooning from blood loss, his scalp tied with a
rag soaked in blood which dripped down his soaked shirt. His cousin-
brother had attacked him with a panga, the local machete-like tools
that killed most of the victims in 1994. Scott put him into our truck
and is still at the hospital now as I write, presumably suturing the
wounds to stop the bleeding.

Not sure what God is saying in this evening's juxtaposition of great
counsel and bloody reality. Perhaps that we should listen to wisdom
but that we can't expect to confine life to the limits of our boxes?
Or that serious rest requires serious regular removals from the range
of panga-wielding feuds? Or to keep a sense of humor in the craziness
of it all? Easier said than done, I'm afraid, especially for Scott who
is actually mucking it out in the darkness tonight.

A life remembered

The Reverend Ammon Sereboya died last night, at the age of 83, friend of the mission and father of one of our nurse-midwives. His life was remarkable in many ways, and we were privileged to carry his body in the casket from town to his parental home for burial, and speak at the ceremony. He was born in 1925 in what is now the DRC, but his parents shifted a few miles eastward when he was a boy, into British- controlled Ugandan territory where he attended colonial-inspired schools. He was a primary school teacher and an Anglican pastor, and he taught at about a dozen different schools over the years. But Scott recognized him for two outstanding life features.

First, he was instrumental in the beginning of the Bible translation project. He served as chair of the Lubwisi/Lwamba Orthography Committee, and throughout the last two decades continued to work on the committee to oversee and check and promote the translation and literacy work. Sitting at his burial with hundreds of people today, I was struck by how his effort and vision contribute to a preservation and validation of their culture. And how the Gospel intersects with that, saying that each people group is valuable and unique and every language worth studying and encoding. What will the impact be on generations of children who learn to read in their mother tongue, who hear the truth in understandable words?

Second, he was married for 56 years, to one woman. Monogamy is not the norm here, particularly not for a man of his stature. Yet he persevered in his call as a man and as a pastor to the principal of "one life, one wife". Scott took some risks to stand up and publicly exclaim this in a crowd of men and women who may not agree. But he expressed admiration for the Reverend and compared him to the Ugandan national bird, the crested crane which mates for life, and people seemed to listen and enjoy the idea. I was at his wife's burial about a year ago. We have great respect for the elders who survived decades of disease and war and hardship, and brought a family and a community into being.

And so we joined our friend Alice, his daughter, and many many others today, lowering the body of a man whose soul, we were reminded by the main speaker, now walks face to face with God.

Africa rejoices . . .

I'm sure our supporters are mixed in their enthusiasm for the outcome of the presidential race in America. But there is no mistaking the enthusiasm here. Ugandans are smiling broadly. Today we had kids chanting "Obama Obama" as we drove by on the road. We actually tuned into the satellite radio early this morning (pre-midnight in the US) and heard projections but tight races . . . then after prayer meeting we turned the radio back on in time to catch Obama's speech, listening as a team, with our kids, here in Africa, his nostalgic rhetoric seeming substantial and historic in the growing morning light. At the very least the sheer fact that a man whose father was Kenyan could become president of the United States gives the average person here in Uganda a sense of pride, of possibility, of redemption, of interest in the potential for America to turn towards Africa in real ways.

In Memory of Daniel

Daniel died today.  He was four years old, and down to skull and ribs and 6.2 kg of feverish flesh.  For three weeks we had tried everything we had to revive him, but we failed.  He suffered, a lot.  Dying of malnutrition is not comfortable.  He drank the proffered milk, right up to the last day, so I think he felt hunger even though almost everything that went in was vomited back out.  More than everything that went in came out, he heaved his life out, so that he slipped downward, losing ground daily in an inexorable march towards not-being.  Ironically I suppose, I had requested the whole family to be present today, father and brother and sisters and mother, to consider transferring him to a referral hospital in Kampala. But when I arrived this morning to a ward of chaos (39 patients instead of the normalish 23-25 . . ), Daniel's father informed us that he was much worse.  He was the first patient Heidi and I evaluated, and we found the family packing up all their scraps of cloth and pans and pills into a sack to go home, though Daniel was arousable at that point, and able to swallow a few spoons of milk.  We discussed referral, but his father pointed out that he would never reach, he would die en route, which was true.  I thought they just wanted to go home to die.  It was agonizing to agree that we had failed him, that there was nothing else to offer.  An hour later they were still sitting on the bed though, as ambivalent as I was, not sure if they should begin their homeward trek or wait until he died.  Then he began to convulse, and have a fever, and we all agreed that we should try a small amount of IV fluid and Quinine.  At least the diazepam for the seizures would perhaps make him more comfortable.  Hospice care should not be a part of nutrition therapy.  Anyway he died at 12:47 pm, still hot with fever, but no longer struggling, vacant-eyed and stiff.  Heidi and Olupa wrapped his body in cloths while the family bustled to collect everything else and his mother began the traditional song-like cry of grief, and escalating wail of sorrow.  Finally Heidi and I slipped into the store room and shut the door and had a good cry ourselves.  When you see a child daily for weeks, when you ask your kids to pray for him by name every night, when you have to be present and helpless through the final agony, well, it is brutal.  

Though this is Daniel's story, not ours, we are listening, looking for meaning in the way our lives intersected briefly.  Is this a clue, to where God wants to tell the story of redemption?  Daniel's suffering?  Our powerlessness, our failure to save him?  No answers today, just a tiny bundle of cloth and a spasm of lament.  Any angels escorting him to the place of no tears did so unseen, as we emerged from the ward to a sky grey with spitting rain.  Faith, not substance, all that we have this afternoon.