Homecoming

Yesterday we braved the long road home, through driving rain with seeps right into our leaky car, over teeth-rattling ruts and twisting switch-backs. The last couple of hours Jack road out on top of the load of trunks in the back, waving and giving a thumbs-up sign to anyone who looked his way, so as his gesture was returned we had the pleasant sensation of hundreds of people smiling and welcoming us back. It was a joyful journey, escorting team mates home. John and Loren Clark, with their son Bryan, have arrived to live and labor with us for the next two years. We've been eager for their help in nutrition and community outreach and nursing . . but so far the fun surprise has been what a precociously articulate, infectiously friendly, and incredibly cute two-year-old Bryan is! They traveled from the US with Heidi, who is returning from a month of HMA, from being in a friend's wedding and visiting her family and church. And their return coincided with the end of Luke's second term at RVA, so he flew into Entebbe on his own this weekend, at least an inch taller, hungry, and full of stories. Last night Ashley and Sarah prepared dinner for our now-expansive team, a real homecoming.

You know you're not in Kansas when . . .

• You come home and find a dead snake on the porch, left not to frighten but to comfort, that someone found it and KILLED it.

• You are turning in an expense report with a line item for "bows and arrows" for the night watchmen.

• You buy the national paper, and the lead article discusses which body parts are most favored by witch doctors for rituals.

• You drive by baboons on your way home.

• You attend a training workshop on nutrition, and walk in to find the current topic is breastfeeding, specifically teaching mothers to express milk from the breast when babies are too sick or premature to suck well . . . and the matronly triple-D size nurses who are teaching have no qualms about handling their own breasts, and in fact they take a sock to make a pretend breast for the males in the class . . and the males happily practice with the sock, not a shade of embarrassment. Only Nathan and I were having trouble stifling our hilarity while everyone else was quite serious.

• You note in the same training seminar that the demonstration doll is so life-like, that no one can bear to leave it lying on the table, so students keep passing it around and holding it like a real baby.

• You find yourself housed in a shadily seedy motel (bare bulbs, dark stairs, lights that blink and send shocks into the shower water, but hey at least there IS a shower) of about ten rooms, conveniently located right at the busiest intersection in town so you can hear every truck all night decelerate and honk its horn.

• You have to pay extra for instant passport photos for a form, because the power is out and the photo studio has to turn the generator on.

• You have to check five stationery stores to find a paper clip (but it is not so onerous, because all five tiny shops are on the same block).

• You wave happily to the police as they pull a nail-studded log out of the road for you to pass, because you know their road-block in a forested area is not a speed trap but rather a security measure in an area where thugs recently carried out an armed ambush.
• You meet someone while waiting to make a purchase who shows off a brand new"50 BILLION DOllAR NOTE" -- which is worth only ten cents because it is from Zimbabwe.

• You are awakened by friendly phone calls at 4 am because the phone rates reduce by 90% or more in the middle of the night, and Africans value both relationship and the economy necessary for survival.

(All of this really happened in the last 48 hours).

BundiNutrition

Our BundiNutrition team meets every Monday to strategize . . . and this week as we discussed our financial situation, I realized I had not contacted our donors in quite a while. We have been blessed this year with $36K dollars . . and we have spent this year, $36K dollars. In other words God provided precisely what was needed. That balance really boosts my faith, and I hope it does yours too as you read. How the spirit prompts one person to send $20 and another to send $3000, at random times, from dozens of states, and yet brings it all together to meet the monthly needs of . . .

• 166 severely malnourihsed inpatients between March and December of 2008 (12 on the ward right now!)

• an average of 54 HIV-infected children per month, 43 motherless babies per month, and 93 moderately malnourished outpatients per month
• 123 families who received dairy goats

. . is truly mind-boggling. Another fun number: 10,000 eggs were churned out by our hard-working chickens for the protein needs of hungry kids!

As I wrote in the post below, we have the privilege of seeing true resurrections of the body. And we pray for those of the spirit, too. I was amazed in the chaos of the ward yesterday to hear some sweet singing . . and found it was the initially hopeless and bitter mother of a severely malnourished baby, who had resisted treatment at first. Over the weeks of care, her child regained health and life, and she regained hope. They were discharged yesterday, truly transformed.

For 2009 we anticipate continuing to need about $1500 per month to fill in the gaps. As much as God has provided through donations, through the goat ornaments, through UNICEF, through sustainability projects, we continue to face an expanding population, uncertain weather and agricultural patterns, family dysfunction, unemployment and need. The BundiNutrition fund allows us to give the cup of cold water, or in this case beans, to the least of these.

If you or your group would like to be part of this process of God's graciousness to those at the margin of this world . . link on the sidebar through "how to contribute by mail" which actually takes you to the WHM donation site, with instructions for either mail or electronic giving. BundiNutrition is project #12371. This is a terribly tight economic time in the world, and we are humbled by those who continue to pray and give at great sacrifice, for the Kingdom to come in Bundibugyo. Thank you.

Time-lapse Resurrection

When Kagadisa was first admitted, I could not bring myself to photograph what seemed to me to be a being who was hours away from becoming a corpse. So I don't have the worst pictures . . but here is a time lapse of several weeks of nutritional therapy and TB medications. Last week he stood for the first time. This week he's walking, with help. In a few days he will go home. Since much of his problem stemmed from being a neglected orphan in the home of a polygamous grandfather and a less-than-able grandmother . . I called his grandfather in yesterday for a pre-discharge pep talk on God's love for orphans and his role as provider. Let us pray that the physical transformation in Kagadisa reflects some spiritual transformation in his family, a renewal of hope, of concern, of responsibility. There is one family member who is a strong believer and perhaps this will be a seed of revival throughout their clan. The need for spiritual and social transformation to accompany physical healing struck me when Birungi Suizen returned to greet us yesterday-- another miracle child, now with curly dark hair, alive and reasonably well, but still stunted and marginal with a pregnant-again mom and an absent father. Praying for unseen as well as visible resurrection.

Now available for downloading....

Now available... our latest prayer letter in pdf file format.  Even better than the snail mail version - it's got COLOR.

Click HERE for the download...(336KB pdf file)

evening prayer

Our team went outside our normal routines this evening, literally, to hold a prayer walk.  We found our Christ School beginning-of-the-year around-campus prayer walk so valuable, we wanted to expand our horizons and include other ministries of the team. In this pre-Easter season of Lent it seemed like a good time to take the risk.  I resurrected from my bed, and most of the team participated.  But we were only half the group, the rest were a handful each of Christ School teachers, hospital staff, church leaders, and nutrition workers.   We read from Romans 12 and 13:  Be transformed by the renewing of your mind (prayers again on the school campus); overcome evil with good (prayers in front of the hospital); the authorities that exist are appointed by God (prayers in front of our new Nyahuka Town Council government offices); and love is the fulfillment of the law (prayers on the mission property).  I find it powerful and poignant to have Ugandans praying for me, particularly those with whom I work daily.  Praying that we would love, would not lose heart, would persevere, would find our reward in God.  It is also powerful to pray against corruption, against the principalities and powers that enslave Bundibugyo, right on their own turf.  The intersection of our various ministries also helps people who work in one area get a vision of God's bigger picture of the Kingdom.  It was a simple hour of praying and walking together, about 25 of us including our kids, clear curiosity from onlookers but no major heckling or opposition.  Not a huge gathering, but perhaps a small seed, the initial path of revival?

Barrenness

Have spent the last two days pretty much in bed . . . which hasn't happened to me in a couple of years I guess.  Friday morning's rounds, teaching, admission, meetings dragged until mid afternoon and included the second dead baby of the week in my long line of waiting consults (newborn, held wrapped by grandmother, nurse screening the crowd of outpatients finally peels back the blanket and notes the grey-green tone of the skin and calls me, I come over and find no heart rate or respiratory effort for who knows how long, shake my head and begin to say I'm sorry as both women begin to wail) . . . the intensity of the ward combined with the lingering effects of this virus pretty much wiped me out.  I've forgotten what it feels like to be so so tired, to be convulsed out of sleep by coughing every few minutes, to arouse for ibuprofen and then lie back down exhausted.  To feel guilty about everything Scott has to do.

Today I'm marginally more alert, and reading at least.  I was struck by Carolyn Curtis James' exposition of barrenness in the book of Ruth.  Since it is a prominent theme in the Bible, she concludes that the role of the barren woman is to remind us that all life, all goodness, all power, comes from God.  That we are all barren spiritually (and to some extent physically as well).  That all our good efforts will be futile without resurrection power.  God chooses the hopeless situation in which to move and act.  

And this is good news, for me at least.  Lying and coughing, I'm completely impotent to do even the most basic activities of family survival, let alone serve anyone else.  And lying and coughing, my perspective on our life looks bleak, I can see more of the struggle than of the victory, and sense inadequacy and failing to a deeper extent, I find myself grieving losses and mourning the present problems.  In that mindset it is good to hear the words of Isaiah (54):

Sing, O barren,

You who have not borne!

Break forth into singing, and cry aloud,

You who have not labored with child!

For more are the children of the desolate

Than the children of the married woman:  says the LORD.

Resurrection will come.  

small comfort

At least Bundibugyo is not alone  . . it seems there is a nation-wide crisis of medicine supply.  Link to this article from the New Vision (national paper)  http://www.newvision.co.ug/D/8/13/675331   in which the districts blame the National Medical Store for inefficiency and the NMS blames the districts for corruption.  From our perspective both are true:  not enough money to buy the drugs, not enough supply within the country, obscure paper trails, hands dipping into the till at every point along the supply chain, lack of accountability.  But the effect is this:  at our local health center, the only medicine available right now was purchased privately by our donors through us, and is locked in a store which only I access.  So the peadiatric ward is overflowing, while frustrated outpatients increasingly abandon the effort to get care.  Any glimmers of hope?  Small ones.  A national consortium has formed to address the issue.  Locally, in our weekly staff meetings I ask hard questions bout money and how it is spent, and our staff is becoming more politically sensitive, wondering who benefits from the current messiness (the first step in understanding why a non-functional system persists).  The young World Health Organization doctor who has been appointed to help the district seems to be struggling to get a hold on the situation, and if he does not give up that may bear fruit.  Scott talked to the Chief Administrative Officer again yesterday and he still strikes us as a person who is moving within the system in the general direction of justice.  Meanwhile a kid with malaria (number 1 killer in Uganda) will be sent away from the hospital without treatment and told to forage in the local private drug shops, where the recommended first-line treatment goes for the equivalent of several days' pay.  What will happen?

Week in Review

Well, the week isn't over, but as it hurtles by I sit to think of a few highlights.

• Luke took off for Kalacha, in Northern Kenya, this morning.  Juniors and Seniors at RVA spend the last week of their second term on "interim" assignments, some adventuresome, some service-oriented, some recreational, some career-option-expanding . . Luke's seems to be a good combination of serving missionaries in a remote and harsh desert setting and exploring a different kind of African beauty.  He's completely out of touch though now, for the first time in our lives.  A bit sobering.

• We hosted a young medical missionary family, and enjoyed sharing our burdens and joys together.  Watched the Veggie Tales version of St. Patrick's story with their 2 and 4 year old kids, and remembered that Patrick began as an abducted child who found God in prayer.  How many of those are right around us, now?

• The secondary school football season started!  CSB defeated Kakuka 2 to 1 in the opening match.  Nathan probably pulled out some hair as his competent and disciplined team threw all drills and control and passing to the winds and instead played typical crowd-hysteria boot-it-in-the-air wild-power football.  Our "boys" were team captains for so many years . . no longer, but we still have a starter and two bench-warmers on the team.  And the kid who scored both goals was kept in school by a gift from Scott to his cash-strapped fellow-medical staff father, so we felt more satisfaction in the investment.  The only sad thing is once again seeing our kid (used to be Luke, now it is Caleb) on the outside again, practicing with the team but never really ON the team, wandering the side lines.  The ambiguity of his status has been hard on him.  Prayers appreciated for his continued good attitude.  

• Had to tell a mother yesterday that her baby was dead, after watching lab staff trying unsuccessfully to draw blood as she held the limp body of a frail little twin.  That is always wrenching.  And I felt like I failed to react to the baby's deteriorating status aggressively enough.  On the other hand, it was a miraculous wonder to watch a 1 1/2 year old little girl with pneumococcal meningitis who was seizing and severely sick on arrival, leave the ward giggling and intact, after a week of ceftriaxone.  Scott picked up a tumor in a little girl with a rare hemi-hypertrophy condition, and we both shook our heads over the dismal prospect of finding chemotherapeutic treatment in this country.  Precious, the child we sent to Kampala for treatment of Kaposi Sarcoma associated with her HIV, died.  It is always like that, one thing to rejoice over and more to weep over.

• Did I mention the putrid smell of our water?  Mystery solved:  two dead birds in the roof tank. This means emptying the system and cleaning and starting over.  As Scott says, the dirty jobs are all his.

• Give-a-Goat 09 begins!  The Christmas ornament fundraiser allows us to transform smooth clean models of goats into the hairy bleating smelly kind, the kind that make milk.  Lammech trained 33 new recipients, and when I went by Sarah told me that 17 had showed up, including Kosimus whom I wrote about last week.  His mother had weaned him early in fear that her HIV virus would pass into his body.  It didn't, so far as we can test, but he became malnourished until we put him on a rescue plan of boxed milk.  Now she'll be able to give him enough calories and protein to survive, available right at her home.  We're doing the distribution in more manageable small batches this year, and the first group is coming entirely from goats bred WITHIN the district through the Matiti Project.  This is a huge step in sustainability.

• Tomorrow:  CSB Board of Governor's meeting and the District HIV annual planning meeting, scheduled simultaneously (the former more than a month ago, the latter we hard about today).  Wish Scott could attend both, and ask some hard questions like why Dr. Jonah's salary has continued to come to the district it seems even though for the last 5 months it has not been given to Melen.  She was given a pay stub that seems rather incriminating.  Speaking of putrid smells.

• Lastly, all of the above is in the context of a week of bronchitis, a wracking purulent cough and migraine headaches.  I felt very sympathetic to baby Jonah who has a similar disease right now.  Being a "wounded healer" and having "God's strength perfected in our weakness" sounds a lot better on paper than it feels in person.  The physical toll of illness makes the emotional and spiritual challenge of survival much more tiresome.

real March madness

If you have not watched English Premier League football in Africa, you have not experienced the full spectrum of March Madness. This weekend we found ourselves scanning for satellite dishes in villages near the game park where we were visiting, and when the Man U-vs-Liverpool game time came around we filed into the only show in town. Picture a barn basically. A windowless split-log tin-roofed structure, with flattened cardboard boxes tacked up over the chinks. Dirt floor, narrow tottering rough-hewn long benches. 97 people (95 of them men) in an area the size of many American basement rec rooms, watching a TV on a table while a sputtering generator huffed and puffed outside to power the connection. Craning necks, shifting numb behinds. Enthusiasm. About half the crowd found it comfortable to remove their shirts (it was a bit close in there . . ). Almost all the crowd found it enjoyable to talk loudly, comment, clap, shout, jump, slap their friends' backs, and otherwise carry on. As the score stacked further and further in Liverpool's favor (much to Nathan's glee), our family became isolated in our stunned and sober stares. In fact it seemed to me that the African crowd merely wanted to enjoy the game and the win, so their passion for the team increased in proportion to the score. By the end Nathan was standing up with his new buddies, yelling and congratulating each other, as Man U was soundly defeated.

Football, or soccer as Americans call it, is truly the world's sport. Probably every person in that room kicks a ball (or a bundle of banana leaves) on a regular basis. Probably every man could imagine himself playing for a European club, as a good number of African star players have managed to make it there. In spite of the noise, the discomfort, the distant screen, the pungent barn odors, the terrible loss, I felt like it was the REAL way to watch football!