On Being Found

We listened to a tremendous (as usual) Tim Keller sermon as a team last night, based on John 20:11-18, the passage where Mary comes to the empty tomb. As he points out in the sermon, Mary is weeping, lost, bewildered, and thinks she has been abandoned. She is aggressively ready to fight for the missing body in spite of her grief. But in reality she has just seen two angels, she is walking through the scene of the greatest miracle of all time, and she is speaking to the Lord. It is not until Jesus calls her name that her eyes are opened to reality. Mary. Just that word, and the entire scene for her changes. Instead of despairingly pleading to fix the burial/spice/location-of-the-body problem . . she is suddenly clinging so tightly to her friend Jesus that he has to tell her to let go!

How much of our lives to we miss? What looks like a bleak road or a disastrous outcome, like loneliness or opposition, may turn out to be the presence of Jesus. Our expectations blur our perception of reality. Grasping for what we think we need, or for what we sense to be our role, we may be missing the whole picture. Like Job and his so- called friends, we completely miss the reality of what is happening, because we assume God to be small or absent, we misread the signs, we operate in the wrong context.

May we all hear our name spoken in love, know who we are and where we are, have the veil rent to see the truth of God's unassuming and gentle walk into our lives. May we be, like Mary, called by grace.

Overloaded by Noon

Here are a few of the issues that bombarded my morning from 7 to noon, not including those that Scott deflected: calling a headmaster in Mbarara to try and get my student a place to repeat A levels, sending messages to a doctor in Kampala about my patient with a rare AIDS- related cancer whose father called me about 8 times over the weekend in distress, finding Jack's missing school uniform pants just in time to get to school, cooking breakfast and packing lunches, talking to my two workers about one of their wives who has declared herself to be dying 4 times in 5 days, helping them process what stresses might be relevant in her life and how her husband could assist her by sending away his two abusive alcoholic brothers who are sponging off his family, holding a firm line with another neighbor for whom I paid school fees to get the orphaned daughters into a better school (rather than returning to the one where the older girl had been sexually abused by a teacher) on the condition that their responsible brother pay for little things like paper and pens, negotiating surgery for a pitiful little boy who survived through our nutrition program but now has a hernia that needs to be repaired, seeing 28 very ill in-patients and about ten consults, coming up with gloves to keep the hospital functioning, receiving report back on a patient I sent for special orthopedic consultation two weeks ago (a bust it turns out, she says her money was stolen on the way and no surgery was done, just a return note with vague reference to ongoing home-based occupational therapy), seeing two staff members, a Christ School student, and a Christ School teacher all with medical issues and a sense of special privilege, and arranging MAF flights and accommodation for team mates and upcoming visitors. So if I forget a thing or two of importance by noon . . . I trust in grace to pick up the pieces.

International Women's Day/ Happy 1st Birthday Jonah

These two events are very appropriately connected.

Today, March 8th, baby Jonah Muhindo Gift Junior reached the significant milestone of 1 year. We celebrated with a party last night, his sisters and mom and a few friends. He loved the cake (!) even though he's not so interested in most food. He clapped his hands when we sang to him, and spent the rest of the evening entertained by his new blue soccer ball, or beating a bowl with a spoon and babbling.

But the real celebration is the woman who labored alone in her grief to bring him into this world, and labors on to build a life for her family. So on this day, a moment of tribute to Melen. A friend of one of our former team mates (who remains one of our real partners in provision here!) sent Melen a timely monetary gift, and both of us almost cried when Scott handed it over last night. She is quietly establishing a quality nursery school. Over a hundred students are taught by her current four teachers (3 of whom have certificates in early childhood education, and the fourth completed S6, which makes them all more qualified than the average primary school teacher around here) . . and they need more space. So she had purchased bricks and begun plans, but was out of funds, until this gift. Melen just got back from caring for the late Dr. Jonah's mother who was hospitalized. She manages the finances and supervision of her three oldest girls in boarding schools, and construction of the permanent house Dr. Jonah had planned on his village property. She has numerous family members living with and dependent upon her wisdom and resources. She is an African Proverbs 31 kind of woman, unassuming, uncomplaining, pressing on, with an inner peace and strength that have been tried by fire.

And so many women like her hold this continent together. We celebrate them today.

Guidance and Counsel

The A level results for Christ School finally arrived (the person collecting them was simultaneously graduating from University, so it took a while). This is the final two years of secondary school, Senior 5 and Senior 6, roughly equivalent to Junior/Senior high school or community college in the US.

Overall the news was encouraging--the highest score was the same as last year, and the number of kids with two principle passes which are required for University, doubled I think (to 18, out of 31 kids who took the exam). I haven't seen any official summaries, but that sounded good. However, there are a few disturbing trends. One is that students who have spent their lives at more successful schools elsewhere in Uganda are still migrating back to Bundibugyo for the exams, being allowed to enroll at the last minute at a couple of the very poorly equipped local schools and then far outscoring our students. This means that the small pool of government sponsorships which are allocated by a quota system (11 I think) will be, at least in part, siphoned away from CSB grads. Second, I think our highest scorers both last year and this year are boys who spent most of their school life also outside of Bundi, though they did come back for A level. This points out that, for the majority who schooled here, our teachers are up against a decade of poor primary school and lower secondary school experience by the time they receive these kids in A level. Combined with poor early childhood nutrition, general poverty, lack of books or a stimulating environment . . we can't expect the school to reverse all of that in 2 years of A level studies. And lastly, the science students fared very poorly. The boy who was top of his class for O level, and our own students Birungi who was also among the most promising kids, did not pass ANY of their sciences. None of the students in the primarily science combinations did well, I am told. There may be a combination of hopelessness, poor study habits, conflicts with staff, attitude . . . but it is very demoralizing for both students and staff to see these results.

So where do we go from here? The staff are busy giving students advice, and the Pierces are I am sure overwhelmed by the 18 kids who qualify for University and have to scramble for fees. We spent a large chunk of time in the last two days making phone calls and talking to trusted Ugandan friends, getting advice for Birungi, as we've done for our other graduating boys. Birungi had dreams of becoming a Clinical Officer, a physician-assistant level health worker. His grades would not even get him into a registered nursing course, maybe not even into a lower level enrolled nursing course. And the overwhelming weight of advice from both CSB teachers and our health center staff is that he should repeat A level, try another school, a new environment, with renewed passion for hard work. Two more years of tuition . . we are pondering the investment and what is best for him.

Meanwhile Luke spent a day in a seminar at RVA learning about the entire college admission process. He has already taken his first try at SAT's, goes on line to research colleges, talks to his very competent guidance counselor at school regularly. He is in an environment that is well equipped (much better equipped than we are!!) to advise and direct.

I think the way that God has overlaid our life such that we face issues with our own biological kids and the kids we have taken under our wing here, is instructive to our hearts. It reminds me of the way things could be, and will be by God's power one day in Bundibugyo. It reminds me that our boys are all very similar under their varied hues of skin, and all longing for validation and success and opportunity and love. And it shows me how important the Pierces' emphasis on counseling really is. Luke has benefited from it, and we would love to see someone here in Bundibugyo devoting their efforts in a similar manner, researching options for school, documenting processes and requirements, connecting kids to scholarships. Because mobility and working with 19 to 25 year old males are two pieces of the package, we're hoping for a mature single guy or a couple. Meanwhile the Pierces have hired two more spiritually-oriented counselors for the school, a former Bible School student sponsored by the mission now giving back to the community . . he has already led three boys to the Lord in the last month. And this week his female counterpart arrived, a middle-aged lady who was formerly a teacher but has a passion for prayer and counsel, and was led to the school by contact through her relative who teaches here. We are thankful for Tibamwenda and Eunice and pray that they will be used by God to lead and direct students in paths of life.

Peace and Justice

The President of Sudan, Bashir, was indicted by the International Criminal Court yesterday on seven counts of crimes against humanity and war crimes.  Pray for protection for the people of Sudan, for resolution, for hope. Pray for the Massos and all missionaries in Sudan, so far in their area things are calm.  Here is a quote from an African perspective, which would prefer to talk this out rather than bring it to court:

"The AU's position is that we support the fight against impunity, we cannot let crime perpetrators go unpunished," AU commission chairman Jean Ping told AFP.

"But we say that peace and justice should not collide, that the need for justice should not override the need for peace."

Stories of Survival

Kagadisa's grandmother began showing up intermittently at the hospital and nutrition programs a few months ago. He had been orphaned and left with her, and as she was scraping by in a polygamous marriage herself, there was little support for her dead daughter's scrawny six- year-old. Back then he weighed 15 kilograms and while unhealthy did not meet critical criteria for admission, so was treated as an outpatient. His grandmother did not follow-up very regularly, and we wondered if his problems were mere neglect. Then after more than a month's hiatus, he appeared again last week weighing an unbelievable 10 kg, a skeleton. Horrifyingly concentration-camp-like. While I see lots of moderate malnutrition, I rarely see a child as severely wasted as Kagadisa. His fragile skin was peeling, his pallor bespoke imminent death. We do not have the best record of reviving children this far gone with our limited care, and I assumed he would die. But no matter how hopeless a child appears, I do not want them to die hungry. We admitted him for slow refeeding, focusing on warmth, comfort, and having something in his stomach. He did not die. Days passed, each morning I checked his bed sure he would be gone. One day I noticed a whole line of healthy dark-skinned normal boys sitting on the edge of his bed. And it hit me that the woman who cared for these children (also her offspring and grandchildren) would not have intentionally allowed Kagadisa to slip away to death. He must have some disease, perhaps the same one that killed his parents. Perhaps TB. We had suspected it several months ago, but none of his lab results supported the diagnosis. I repeated everything and called in our experienced senior nursing officer, who agreed we should try putting him on therapy. He's up to 12 kilograms now, in just a week. But he's still too weak to sit or even hold his head up very long. When Scott snapped this photo and showed it to him, he smiled for the first time, a small hint of a crooked smile. I hope we will be able to show him a much more accurate picture of who he really is by the time he leaves. And I hope to see a real smile, then.

Kosimus' mom weaned him very early and very abruptly, in her effort to protect him from her own HIV infection. New evidence is showing us that early weaning (around six months or earlier) in settings like ours may save a few HIV infections, but this increment in survival is far outweighed by the decrement in survival caused by deaths from malnutrition and diarrhea. When I saw Kosimus' downward sloping growth curve, I was sure he was truly HIV-infected. But so far two tests have come back negative. It seems he was just hungry, that his little five-month-old body could not manage without breast milk. Now he's slurping boxed milk, and his dedicated parents both take their turns, investing in this little chip of a human who will long outlive them. We hope.

Ngonzi was also just hungry. His pregnant mother lied to us, even bringing an official letter from her village chairman declaring him tobe an orphan in her care, hoping that would buy her better care. Within a few minutes we figured out the truth, that she had become pregnant again too quickly and that he could not survive on her dwindled breast milk supply. We assured her that he was being admitted and fed no matter what story she told us .. so she came out with the truth. I suppose you could call this "uncomplicated" malnutrition, a simple lack of food without underlying disease. But I think poverty is inherently complicated.

And lastly, Peter John. A week and a half ago his weeping sister came to our door on a Sunday morning covered in his vomit, and he was lethargic, cool, and near death. He had been discharged from a long hospitalization (in which we diagnosed AIDS) at 10 kg and returned weighing 8, a 20% loss of body weight, severe dehydration. This morning, however, he toddled up to be first in line to be weighed, a 2 year old holding my hand, wearing nothing but an ankle bangle and a string around his waist, smiling. At 10.6 kg, he is back in the land of the living. And I have come to respect his sister Grace, who cares for him with a playful bond and a fierce dedication that outshines most mothers, perhaps also aware of her own impending mortality, investing in her two little siblings. A heavy burden for a 17 year old girl who has already survived abuse, and who cried again today recalling the details of her mother's death. But she smiles when she looks at Peter John, because she sees hope there, too.

These are a few of the stories of survival, stories that are still

being written, stories that may have joyful or tragic endings. And stories which I hope inspire prayer. In the last 24 hours I also saw a chubby baby Gloria, whose mother and twin died the day she was born, and whose survival looked equally hopeless last November. But her grandmother Bena's story touched visitng Barb's heart, and I know Barb recruited prayer, and here she is alive and well. And little Mumbere, still plugging along on treatment for AIDS years after his mother died, a mischievous grin and a frail slip of a grandmother. I noticed his chart: #4, meaning he was the 4th person to be started on anti-retrovirals at Nyahuka Health Center years ago (now we're using chart numbers in the 700's). Many prayed for Mumbere over the years, too. The milk we can measure, the medicines we can count, but the intangible realities of unseen prayers and healing power completes these stories of survival.

Pilgrim's Progress to 11

Jack turned 11 today, and chose "Pilgrim's Progress" as his birthday theme. We've read the "Little Pilgrim's Progress" several times, and this past Christmas Trinity church sent the kids a cartoon version. It actually is a good theme for Jack, because he's exceptionally literate, spiritually sensitive, and ready to do battle. Today was a typical Bday challenge for us though, juggling patients and family, and without Scott's input I would not have made it. UNICEF showed up unannounced for the key meeting that would determine whether we continue to get milk for malnourished kids for 2009. The doctor could not have been nicer, but I was also honest when he came just as I was leaving the health center, that I had to make it quick for my child's sake. I did not think it right to ignore a once-a-year visit from Kampala that determines over ten thousand dollars worth of milk formula for dozens and dozens of the neediest children. But I also did not want to short change Jack. In the end, with lots of help, it all came together, we passed inspection, signed the contract, made dinner, and organized the party!

Back to Pilgrim's Progress. We set up a full dramatization all around our yard, with stations for the Slough of Despond, the Wicket Gate (with letters from the King, and maps, and Annelise Goodwill snatching them from David Worldly Wise), the Interpreter's Kitubi with Bible stories and posters by Scott, a relay where the burdensome backpacks (loaded with heavy medical tomes) were dropped at the cross and Ashley and Sarah the shining ones put the mark of the Kingdom on foreheads. There was a Palace Beautiful refreshment stop (yours truly as the motherly Discretion), and a dangerous run through the Valley of Humiliation where Caleb as Apollyon pelted the kids with little mangos. Then the Valley of the Shadow of Death (blindfolded) and Pat tempting them to stop in Vanity Fair, the cage, the stile (we happen to have one between cow pastures) where they were captured by Nathan as the Giant Despair and locked in Doubting Castle (water tanks). A quick view from the delectable mountains gave the stamina to fight out of the Flatterer's Net (who looked suspiciously like Worldly Wise) and make it to the Celestial City for the Birthday Feast of spaghetti and cake. We have such a game team, dressing up outlandishly and going along with the program willingly. Nathan achieved the distinction of (according to him) the most ridiculous he has ever looked in his life. Jack was honored, and Quinn will probably not forget it soon, especially the very real terror of being so close to the cow. By the end of the evening Jack was plunging back into the tears that were plaguing him a few months ago. I think it was the anxiety of worrying that he would feel sad on his Birthday that put him over, but I also think we are under a significant amount of spiritual attack right now, sickness and weariness and injuries and discouragement. So Pilgrim's Progress encouraged my heart, too. As Jack sobbed going to bed "At least I know that I won't feel this way in Heaven . . ." Amen. We journey on in that direction.

collateral damage

In the theme of post-victory counter-attack on those whom we love, and in the theme of prayer . . . Ivan broke his arm on Saturday. It is his second broken bone in four months, both after relatively minor injuries. His school friends provided traction to snap the displaced bones back into alignment BEFORE they went to a teacher for permission to be brought to the doctor, so he was pretty close to passing out from pain when Annelise brought him up. A half-cast splint and TLC and rest revived him, and now we're trying to send a bottle of milk down to school daily to calcify his bones. It reminds me of Luke being injured in his first month away at boarding school . . . Ivan is 14, and though resilient, this is hard. Then last night I found out that my mom's eyesight has blurred significantly, perhaps related to problems from her old glaucoma surgery. Since she has both sever glaucoma and an epiretinal fold which impair her vision, and since she lives alone and drives about caring for numerous older relatives . . . more loss of eyesight would be extremely difficult for her. Would appreciate prayer for healing for both.

In Praise of Pee

Forgive the title, and be thankful I did not have my camera today, but 

I wanted to share the good news that after well over a year of effort, heart-ache, corruption, and disappointment, Kweyaya Paulo can pee. He is, for the first time in his five years, urinating normally out of normal openings. The hole in his stomach is closed. He is smiling. His mom is smiling. We are thankful for our gracious supporters, because our ministry fund allowed us to pay for his transport and surgical care at the main Church of Uganda hospital (not free) in Kampala and avoid the hopeless passive-aggressive public hospital where he had languished for months. His post-operative care was done through the charity ward at International Hospital, the HOPE ward. Also this morning we were able to send blind and paralyzed Kabasunguzi Grace and her mother to a rehab program in Mbarara, where they are encouraged to press on with her care. These children would otherwise simply be relegated to helplessness, sad reminders of injustice, because the access to specialty care presents too many barriers to their families. But for a hundred dollars or less I can usually hook them up with some services elsewhere in the country. It is a small side-bar to our normal patient care, but one that reflects the value of even the weakest and poorest special-needs kids, and I'm grateful that our financial support through sacrificial giving to the mission allows us to pass the blessings on.

A weekend of life

The weekend was full, and I am very grateful for the way Caleb's 14 fire-cracker sparkling candles matched the renewed sparkle in spirit that accompanied the love extended to him on his special day. He missed Luke being here, for the first time ever. A lot. But Luke made a creative collage of photos they had taken together photo-booth style using a computer cam, and emailed it in. The whole team descended as a light evening rain tapered, and we cooked pasties (meat and veggie pies) in the outdoor oven, made home made ice cream, opened presents ranging from just-like-new jeans from the used clothes piles in the crazy Saturday market, to a David Pierce sarcastic take-off on Monopoly geared to Bundibugyo with cards like "Pass go, take another wife and get another child" or "Your National Social Security Fund matured. Wait four turns to collect." Caleb was quick with the one- liners and kept us all laughing late into the night, as he allowed us to try out the new hammock made from a bright red woven African cloth that the singles brought him.

And this morning, we took the Elijah advice. We escaped, to the closest bit of wilderness available, for a nearly-all-day hike in the Semliki forest. This is a lowland tropical rainforest with more than 300 species of trees and more than 400 species of birds . . . and NO PEOPLE. We hiked for probably about 10-12 km, through sun-speckled high-canopy areas of ironwood and low scrub, through dense jungly palms and vines, through sulfurous vents steaming with hot springs, through sucking mud. We saw chimp nests (2) high in the trees, the temporary leafy structures they build for napping in the day. An empty aardvark hole. An intersecting trail stomped with elephant prints and littered with their dung. Five different monkey species crashed through the canopy above us: Grey-cheeked mangaby, black-and- white colobus, blue monkeys, red-tails, and baboons. The baboons are the boldest, and there was an amazing moment when Jack imitated their throaty call, and had a conversation. Really. This huge baboon was right over our heads in a palm tree staring at us, and he and Jack were calling back and forth. Hornbills and palm-nut vultures and bee- eaters and ibis flew into view. We glimpsed a rare monitor lizard scuttling through dry leaves across the path, and the elusively shy sitatunga antelope. One of the bizarre moments: Sarah's cell phone (which never rings) got a call from her family which was all together to celebrate her grandmother's 80th Birthday just as we were on a rotting-log bridge that broke with Nathan on it (a short fall) and we all ended up in a swarm of biting ants, running and trying to get out of the bog and the insects, and I heard Sarah saying "happy birthday grandma but I have to go we're being attacked by biting ants in the forest". Probably the most unusual conversation her grandmother had that day. We ended up at the "female" hot spring, a clearing of crusty rock and marshy grass where boiling water bubbles to the surface, and reeking steam lifts slowly into the hot air. It is believed to be the place where the spirits of women who die roam, and local women come to make sacrifices there. We came to boil eggs, very entertaining to drop eggs into the pools of bubbling mineral-laden water and cook and eat them. Home to hot soup and family time, all in all a day of complete break from routine and normal life, of being temporarily unavailable to anyone else's crises, of walking through untouched wilderness thinking about life from God's perspective.

Which means that Monday comes tomorrow morning, inevitably, and without much preparation other than the rest of soul that accompanies a good weekend break.