Elections

Elections were held yesterday in Nyahuka, which used to be a sleepy
crossroads when we moved here, and is now a rapidly growing and
organizing town council in need of a mayor. There were a half-dozen
contenders, but the top two were a relative of our member of
parliament (think, insider, lots of clan pressure to keep the money in
the family) versus the local businessman who originally hails from a
neighboring country and a minority religion. Since the latter is
perceived to be a bit lighter-skinned and a relative outsider (in
spite of decades of residence) he ran under the nickname, Obama.
Really. People connect him with Obama, and he's been quite popular.
People respect his business skills and hope he'll be less under
pressure from local interests. Initial returns had him in the lead by
a 2 to 1 margin, and people began to celebrate. But the news of the
morning was that the other man won by 73 votes (in a city of
20,000 . . but maybe only a thousand voted, not sure). And the gossip
on the street was that the parliament-connected politician was paying
about 2 dollars per vote. So Obama and his supporters zipped off to
Fort Portal to protest. I believe the political process probably has
the greatest potential for good, or evil, than any other grouping of
people here. So we pray for clarity and justice.

In the meantime I arrived this morning to learn that Nuela had taken a
sudden turn for the worse around midnight last night, and died. I
would like to picture her now in the rich brocade robes and nose-
diamond-stud of Ezekiel's story, a beloved young woman of grace and
wholeness. I would have liked to say goodbye to her grandfather, whom
I may not see again. Very sad.

Ezekiel 16

Is the passage I meant to refer to in the post below.  The story of Nuela made this Gospel-picture come alive for me.  Read it.

Trench Slogging to Hope

In a 24 hour period on Monday, 5 kids died on the Pediatric ward, including the child I wrote about with such hopes mid-day on Monday, and another who breathed his last as I tried to revive him that evening, leaving my dinner cooking on the stove as the sun set and zipping down in response to a distressed call from a clinical officer. Tuesday we met for three hours or more about the future of one of our team's ministries that needs direction and funding. Today we met for another three hours with community leaders to get advice about the rash of break-ins. Earlier today I saw a newly diagnosed AIDS patient: a girl who is within a week of exactly Jack's age, her grandmother dating everything from the first rebel attack, which means this girl and Jack were both embryos when her mother and I ran. Now she's an orphan, half Jack's size or less, with a potentially lethal complication of those stressful and uncertain months in utero. Another mother today told me a disturbing tale about her child being lured away by a stranger whom she suspects was a child trafficker, right under our noses there at the hospital. Heidi challenged us to pray along the Peacemaker lines: that all of these situations would be opportunities, in proportion to the difficulty, for God to be glorified. It is a bold prayer and one that injects hope into the trenches filled with muck.

So, a few glimpses of glory. First, Nuela, a little girl from Congo whose name refers to her being born at Christmas, though her grandfather is uncertain WHICH Christmas it was. I'm guessing she's about 4. When her father died, his relatives shunned her mother and her, and her mother ran away. Then the paternal relatives sent word to the maternal grandfather who lived in Uganda to come and collect the child who was very ill. So in a counter-cultural move (children belong to the father's family in patrilineal descent) this somewhat elderly lone widower of a grandfather carried this terribly ill girl whom he had never before lived with back to Uganda and to our hospital ward, and there they are. She is listless and swollen and scabby and miserable. But I find it remarkable that her grandfather is making this effort and pray it is a story of redemption ( ).

Second, on community, Jack was invited before the first day of school this week to visit one of his best friends, Ivan, who lives pretty much on his own in a small room in Nyahuka. Ivan had saved back some of his school money and bought eggs and cabbage, and he and Jack cooked themselves dinner on the charcoal segili, then played cards until dusk. While many friends hang around our house, it was rare for one of our kids to be invited to someone's home, alone, as a human being not as part of a missionary family, just to be a guy. He had a great time.

Third, partnership. Though I dreaded this week with several of my missionary co-workers gone. . . Ugandan colleagues have shone. Our nutrition workers Pauline and Baguma Charles have been fantastic. And I realized this morning I was rounding with three of my favorite nurses! One is about to begin maternity leave any moment, the second is a mature lady (like me!) whom we sponsored to become a nurse years ago, and the third is an energetic and capable young man whom we sent for training after seeing his faithfulness over the years, who just finished his course. And to top that off, one of the three medical students we sponsor from the Dr. Jonah fund is here for a week of his school break, a breath of competence and a hope for the future.

It strikes me that these themes: prayer, community, partnership, compassion, emerging leaders . . . are the core of what we've asked God for this year. And in a week that seems mired in evidence of evil, those payers are being answered.

ICU and CSI

This morning, I was trying to run an ICU and Scott was trying to run a CSI . . .

Well, we were wishing for those two things. An Intensive Care Unit conjures images of glistening equipment, beeping monitors, tangles of IV lines, humming oxygen. Picture instead, a listless cold baby in shock, wrapped in a filthy cloth, unconscious and grunting, on a bare mattress with a litter of spent IV cannulas as two nurses use a razor blade to shave his scalp and a rubber band to try and pop up his empty veins, his mother and aunt seated on a low wooden bench anxiously watching. When they were unsuccessful after ten minutes, I decided to try an intra-osseous line. In a baby the tibia is not all that hard to penetrate, and inside the bones there is a spongy sinus of tissue that absorbs fluid well. The trick is to jam a needle into the bone, which takes more courage than fine motor skill. I do not have any more sturdy short needles designed for this task . . . so instead I used a lumbar puncture needle and merely held it in place in his floppy leg, trying to keep clear of the copious and odiferous diarrhea flowing out. We also don't have any syringes bigger than 10 ml, so it took 45 refill-and-push refill-and-push procedures, counting out loud, to get a half litre of fluid into his body. When we started I could not feel any pulses, by mid-way his heart was racing, and by the end he actually put out a little urine and began to move his arms, warming and looking a little more life-like. All the while I was praying him back from the edge. At first his mother claimed he had become sick only that day . . and I worried about cholera, which can rapidly kill. But towards the end he vomited a brown mixture of herbs, and I slowed down enough to look at him more closely and suspect that he had been dosed from above and below with local enemas which are part-witchcraft and part-local lore. Delick still may die, but I left him on antibiotics and anti-malarials and with a bag of blood warming for transfusion. And he was next to another baby with severe malaria (an advanced case with very high parasite counts) and another with severe anemia (from sickle cell disease), any of whom would attract a bevy of specialists and thousands of dollars of care if they walked into an ER in America, but who will hopefully limp through on a ward of 30 patients staffed by a couple of nurses and me.

Scott, meanwhile, was investigating a crime scene, as if he had nothing else to do with half his day. The thievery spate continues with this time someone who KNEW THE COMBINATION opening a lock in a temporarily vacated house. Interestingly the thief "borrowed" a bicycle and pair of crocs to lug the loot, and Scott and others were able to follow the characteristic tread in the muddy road (it rained hard last night) for about a mile up the road before losing the trail. The mud-caked bike and shoes were returned, and the door closed and locked by morning. We had already initiated a night-watchman plan (which starts tonight, unfortunately too late to prevent last night's episode) and invited the local community leaders and police chief to lunch on Wednesday to express our collective team distress.

These two mornings starkly remind us what we are up against: our enemy is not the desperate parent who nearly kills her baby with herbal enemas, or the desperate person who takes sugar and a mattress and dishes from a house full of much more valuable things. Our enemy is the force of evil itself in this place, the strongholds of disease and ignorance and greed and jealousy and hatred and laziness and fear. And our enemy is not only external, but we have to deal with our own self-righteousness and self-protection and entitlement and judgmentalness. A tall order for sure, which is why the cross had to be so gruesome and bloody, so serious and painful. God's ICU for our own CSI.

REAL missionaries . . .

As part of yesterday's hooplah, the pilot of the AIM-Air plane ended
up hanging out at our house, and in between driving and supplying
snacks and water I had the privilege of doing my own interview. It
was RVA that provided the connection, I find that it is a way that
most missionaries in East Africa are somehow related. But as we sat
and talked I was awed by the real commitment and experience of this
family of AIM missionaries. The pilot's grandfather entered the
Belgian Congo in 1922 in a canoe with CT Studd, one of the pioneers of
19th and 20th century missions. His grandparents served over 40 years
as did his parents, and he and his wife are on their 26th year . . .
with four kids who will probably follow into this fourth generation.
Makes our saying "we've been here over 15 years" sound pretty paltry.
I was fascinated by first-hand accounts of Congo when it was a
functional empire of railroads and order, as well as by first-hand
accounts of the rampant corruption and deterioration that make it
almost impossible to survive there now as an outsider. But more so I
applaud the quiet heart of mission aviation, to connect people with
gifts to share in preaching, healing, teaching, etc. with those in
very remote and difficult terrain. It is often Africans ministering
to Africans these days, but the plane still enables those with more
opportunities to reach those with less. It reminds me that we are a
young mission, and I humbly soak in the history of those who have laid
down their lives long before we were born.

Kabonesa's Story

This is the title of a short booklet that was recently translated into Lubwisi by the literacy project associated with the Wycliffe/SIL Bible translation work. It tells the story of a young girl whose father dies of AIDS, and how she helps her pregnant mother and then siblings. The format of a story, with simple line-drawing pictures, is an effective tool to bring up all sorts of issues: stigma, the response of the church, medical facts, family dynamics, the emotional side of HIV infection. For most of last week the literacy workers held a workshop, largely populated by people living with HIV/AIDS, to teach them to read and use the book for community education. The hope is that dialogue will combat rumor and misinformation, and encourage testing and care. And that the Gospel will be what it is: good news, that life has come, that death is reversed. And that the process will promote READING in general, and the use of the indigenous language in particular, to speak to peoples' hearts and give them value. A tall order for a slim booklet!

The week culminated with a plane-load of media, as Christian Broadcasting Network, Moody Radio, and Wycliffe sent in a team to interview people, film songs and dance, and generally lend a stamp of approval and admiration for the work that is being done. We played only a minor chauffeur and communication role to enable the real stars, the literacy workers and the people struggling to survive with HIV, shine. Still it was fun to watch from the side lines and to catch the sense of hope!

Sunshine and Beans Galore

Yesterday was one of the longest but most worthwhile days of the year - our quarterly Kwejuna Project Food distribution. Clouds which had smothered us all week lifted for a gloriously bright and hot day, allowing travel and transport for all the families involved, and no small miracle because it has rained heavily for the 12 hours since we finished. A real gift in response to prayers. The day began ominously when we discovered the store room where we were keeping all the food had been broken into during the night, the locks pried off with a crow bar. Again, either angels scared the thieves away or they opted for subtlety over greed, because only 4 of about 250 bags of beans and a few bags of salt were missing. And the oil delivery had been delayed, so the most expensive component did not arrive until morning.

As always, the women gathered early, jostling for their places on the lines of waiting benches. Each was registered and interviewed individually by one of five nurses and trained volunteers, and any gaps in care discussed, counseling given to those that were not taking their medication or attending regular clinics. Then I reviewed each child's status, sending the infants for a PCR test done with a drop of blood on filter paper that can identify the presence of virus earlier than our conventional tests, allowing early treatment. Uganda's new policy is to treat ALL infected children under the age of 1 year because of the historically high mortality in this group. These tests are sent to a lab in another part of the country, so many of the women were also looking for the results from last quarter's tests on their babies. We would search through the file of papers while they searched my face, more skilled in reading my emotions than the writing on the page. All but one new result I gave back yesterday was a negative, very fun. Each woman and child was weighed and measured, to track the impact of the food. About 80 of the 259 opted for family planning services which we offer on the spot, allowing women to remain non-pregnant as they care for their own health and their child's. Two elders from the local church sat in a side room to pray for any who wanted prayer. Those who were waiting in between weighing and testing and prayer stations sat sipping the cups of porridge we provide to give them stamina through the day. It takes about 5 solid hours to process everyone. By 3 they re-gathered, the only time in the day when the entire group is addressed as a whole. Scott preached briefly about the Good Shepherd who goes to find His lost goat (we don't have sheep here)--appropriate in a day when we are counting and numbering everyone, calling them up, and demonstrating that they are valued. The day ends with each person being handed a 20 kg bag of beans, a kg of salt, and a large bottle of cooking oil, plus a small transport stipend to get all of that home.

And as always, I came away from the day awed by team work. Locally, our entire team present right now in Bundi pitched in, working solid through the day without a break to serve these women. Another dozen health workers and community members joined us, lifting bags or praying or recording blood tests. The entire process is made possible by former team mate Pamela's heart and vision as she raised the funds from a very generous couple from her church in New York, whom we prayed for as a group yesterday. It was our first time, I think, to manage without Pat, who is usually the soul of the entire process on the ground but is currently on HMA. After some rounds of cheering as Scott greeted the women and announced what they would take home today (biggest cheer was for the salt) . . . he told them that Pat and Pamela would both be back for the next distribution in July and the entire place erupted in a spontaneous and thunderous roar of shouts. Pat and Pamela have made a real impact on the lives of HIV positive women in Bundibugyo. There is even a pair of two-year-old twin girls named after them, who happily escaped transmission of the virus from their mother, thanks to this program, and were toddling around yesterday.

By 5 we were beat, drifting back to our house for a late team meeting . . . which was subsequently taken over by the unexpected arrival of a delegation from a nutrition NGO called NuLife. Along with a Save the Children representative, they decided to come and meet us to set up plans for the training of community nutrition outreach volunteers within the next month. Very good stuff, I do think their coming was a God-send (literally), just a lot at the end of a long and hungry day. By 7 it was almost dark, rain was threatening, our kids were past the point, the meeting was not ending . . . so we invited them to stay for pizza, and the same great team who rallied through the distribution re-rallied to make dinner and serve our guests. As it began to rain, we sat by candlelight under the bougainvillea eating hot pizza and laughing with this group of energetic and committed Ugandans.

A real Kingdom day.

Why we're here

Today one of the boys who was implicated in breaking and entering a mission house last week resurfaced, audaciously delivering a note begging for money to a different missionary. Within a half hour he was seen slinking back around his home and pulled into a meeting with our local government and mission leaders. There is talk of caning (beating), talk of requiring work to repay the debt. There is not talk of jail, because the three boys who stole the money are juveniles, and there is no functional juvenile justice system beyond the wrath of the family (and that may be more dangerous than the police; I've known cases where the family burns the thieving child's hands to teach a lesson). The sad fact is that in this case none of the culprits have a parent who cares enough to administer a just punishment, or that feels enough responsibility or shame to force compensation. And in a country where neighbors steal the food right out of each others' gardens, three boys taking money from a missionary home just doesn't invoke a lot of public outrage. And this has left our team feeling betrayed by the slow pace of the response.

Which has left us also feeling discouraged. Loving Bundibugyo is like having a baby with colic. I know, because I've been there. The baby cries and is so unpleasant that no one else wants to be around him. Bundibugyo is that way at times: hostile, dishonest, unjust, apathetic, manipulative, unfair. It is not the quintessential community of mythical cooperation, where poor people work together for the common good, or where those who want to help are respected and welcomed. Centuries of fear and lies have driven wedges into every relationship. It is not just the physical harshness of bugs, bites, infections, rats, snakes, mud, heat . . . though those are painful to watch our team mates suffer. It is so much more the entire societal system that conspires against Heaven.

A couple of days ago I did some half-hearted CPR (because I was pretty sure there was no reversing this death) as Oscar, a 1-year old, faded out of life, those last gasps of breath signaling that his soul had slipped away, that his heart had petered out, as his mother threw herself in agony to the ground. He had been admitted for almost two weeks, and we thought we had caught his TB infection in time to save his life. But his reserves were too strained, his margin too slim. Today a frightened toddler with terrible malnutrition cried while I tried to understand her grandfather's explanations: he did not know the child's age because she had just been dropped off at his home, abandoned by her mother after her father died. Just two examples of how blatantly WRONG this world can be. Evil should provoke us, to tears or to battle. We should not gloss over the thieving, or the sicknesses. But to continue on we have to choose which wrongs God has called us to pursue, and know when to protest and when to merely accept the suffering.

Because that is why we are here: the world goes not well. But we serve One who has overcome, by love, the worst that evil can throw at us.

What we're up against

The national paper published cut-off points for students for admission
on merit scholarship to various courses of study. In a country where
over 50,000 students qualify for university, there are about 25,000
freshman places in all of the universities combined, and only 4,000
scholarships. Of those 4,000, 3/4 are merit-based and 1/4 (1000) are
distributed among the nearly 100 districts in Uganda (11 per
district). Those are the 11 spots we aim for at CSB . . but sadly
we're finding that families whose children attend wealthier Kampala
schools then trickle back to Bundibugyo at the last minute to take the
qualifying exam from here, snapping up the scholarships. And the
scholarships are supposed to be allotted 75% for sciences and only 25%
for arts . . yet we have difficulty getting anyone to pass sciences
highly enough to get in, and most of our students opt for arts
combinations. For medicine for instance, the total points required (a
complicated system that assigns numbers to various scores so that
higher is better) is about 50. We have yet to break 20 at CSB. Today
I sat with one of our boys, who will be lucky to break 5. In other
words, we have a LONG way to go. Beginning with marginal prenatal
care, poor nutrition in early childhood, lack of early stimulation,
absence of books or libraries or head start programs, crowded and
poorly run primary schools, and a constant battle with energy-sapping
infections, a struggle to get text books or to retain qualified
teachers, our students have an uphill battle from birth. This is not
a one-generation process. Perhaps the children of the boys who now
spend their vacation days poring over our books, eating lunch with our
kids, playing soccer and scouring for mangos, will be the ones to
reach university routinely. Or their grandchildren. We are up
against the "spiritual forces of evil in the heavenly realms" as it
says in the Bible, the systems of injustice which perpetuate
inequality and despair. And the battle requires a very long view.

A painful praise

We had excellent, encouraging, amazing news this weekend: Caleb was offered a place in the 10th grade class at RVA for the 2009-2010 school year. Since Luke has thrived, and since Caleb's options in Bundibugyo continue to narrow, and since he misses Luke so much, and since we have asked God for the gift of the ability to send him to RVA . . . we are grateful for this. The admissions counselor and guidance counselor had both told us that an opening was unlikely for next year; it is the largest (most full) class in the school. So once again we are amazed by God's ability to bring something out of nothing, to open a path where we saw none. But the good news carries a small barb, of course, the reality that our family will once again be shaken and shifting, that now 1/3 of it will be in Kenya with 2/3 in Uganda. That Jack will have to experience the grief of saying goodbye to another brother for large chunks of the year. That the continuous living together we have known for the 14 years of Caleb's life will end in a few more months. And so we praise as we wince, aware that this is a blessing from God, but one that also extracts a painful cost.