GOOD NEWS

Just got an email from Scotticus, who says Kevin woke up, is breathing
on his own, and even talked to JD a bit. He will rest now for the
night. This is so miraculous, such good news, my fingers tremble even
typing. Of course there is far to go and much to know, but even this
degree of recovery was faster and further than was anticipated. So
grateful.

Continuing to pray

Thanks to all who labor in prayer for the Barts.  Tonight the only staff member left at CSB who has been serving since the very beginning spent time reminiscing with us, which was helpful for both his family and ours.  He glowed with hope that if God orchestrated this near-death event to occur with such miraculous timing and location for rescue, surely He can bring Kevin through the coma.  We have lived through too much inexplicable suffering in Uganda to make any prediction that we know God's intentions, except to testify by faith that His actions are motivated, always and in every situation, by love.  It is mid-day Friday in America, and over Friday evening and night the slow process of warming Kevin's temperature back to normal and then withdrawing the paralyzing and sedating drugs will occur.  Perhaps by Saturday, but perhaps later, there will be subtle signs that will give the doctors and JD some clues about the extent of injury Kevin's brain incurred in the long period of his cardiac arrest.  This period of unknowing is very difficult, like the disciples huddled in the upper room, dreading and assuming the worst from Friday to Sunday.  Let us pray that we, like they, will experience the amazing resurrecting power of the living Christ.  

Here is the link to the Bart's blog for updates:  http://kwegesiya.blogspot.com/

PLEASE PRAY FOR KEVIN

Kevin Bartkovich, our long-time team mate and friend, is in the hospital in Durham NC in critical condition.

He had gone out for a jog with Joe yesterday and collapsed within a hundred yards of the house. Thanks to Joe's calls for help neighbors called 911 and started CPR. JD ran out to find him with no pulse or breathing, and continued the CPR herself until the ambulance arrived. He was in ventricular fibrillation, the kind of arrhythmia that causes sudden death. It turns out that he has a previously undiagnosed congenital anomaly of his aortic valve, which occurs with some frequency (at least 1 out of a hundred people) but does not usually cause any symptoms until mid-way through life, and then the first sign can be this kind of sudden collapse during exercise. The paramedics had to shock his heart three times; the third time in the ambulance finally got it beating again. Kevin was without vital signs for at least 5 to 8 minutes. In the Duke ER he did try to fight the tube in his throat for breathing, and opened his eyes, so those are hopeful signs. He is heavily sedated, medically paralyzed, on life support, and cooled down to a near freezing temperature, all to try and minimize the damage to his brain from the long period of no oxygen. Preliminary tests indicate he did not have a "heart attack" (myocardial infarction) or a stroke; the collapse was due to the electrically ineffective rhythm his heart went into.

Yesterday was the Bartkoviches' 15th anniversary. I can only barely imagine JD's experience of finding Kevin lifeless on the street and doing the first CPR she's ever had to perform, on her own husband. By the time she got her 4 year old twins cared for and got to the hospital, she had no idea if Kevin was alive or dead, since she had last seen him put into the ambulance after the first two attempts at defibrillation were unsuccessful. Her family, and many friends, have rallied around her now. His prognosis is far from clear, he is certainly not out of the woods, but we hope and pray that he will recover without major impact on his brain. He will eventually need a replacement of the abnormal heart valve.

Where is God's mercy? We can not see it as clearly as we would like; we say by faith that it must be there. Here are two glimpses.

One, since this event stems from a life-long silent heart defect, it could have happened any time during the Barts' ten years in Africa. Kevin's final weekend he hiked over the mountain pass with teachers from CSB, a strenuous endeavor hours from any road or phone, not to mention hospital. He coached soccer and jogged around the school track. If v-fib occurred here, he would not have survived. Even if he had gone down most places in America, he might not have been revived in time. This happened five minutes from one of the premier medical centers in the world. This is a small vision of the way God sends His angels to keep us from stumbling, even when we don't know it.

And glimpse number two, this occurred in the midst of Christ School crisis. Yesterday the students were becoming very restless and threatening violent strikes, the immediate issue being the school's new policy of having a "spot exam" (pop quiz) period at the end of every day. The bigger issues are complex, related to being teenagers, poor, reckless, with little to lose, no skills for non-violent conflict, distrustful, many with histories of abuse and abandonment. We got the news about Kevin while students and staff were in the midst of meetings over their complaints. The meetings turned into prayer meetings for Kevin. This was a needed reality check and change in focus, at least for the day.

Please pray for the Bartkovich family, for bigger views of God's glory and merciful care as they walk through the valley of the shadow of death. And pray for the school that they devoted a decade of their lives to found, for us to see God's glory and mercy there, too.

Hitting the pavement

Tim and Doug landed Monday morning: we basically waved Luke through security and as he entered the ticket line for his flight back to Nairobi, we ran down the stairs to the arrival area to greet Tim and Doug. Grief, parting, juxtaposed with greeting and beginning new relationships. Doug had been en route without sleep for two days so he opted to crash into bed on arrival, but Tim had spent the last several weeks within an hour of our time zone (in Spain) so was up for immediate adventure. Since we had a lot to accomplish in one day, we left the kids at the ARA and Scott and I split up, and I was very thankful for Tim's company. We plied the minivan taxis out to Mukono where our student Basiime gave us a campus tour of the impressive Uganda Christian University, the Anglican-founded institution. He led us to a professor whom we had contacted earlier as a potential educational consultant, for a brief but hopeful meeting. Back into Kampala, crawling traffic, crumbling side walks, profusion of wares, bodas weaving in and out of traffic, sunshine and breeze. Next goal was the top of Namirembe Hill where the Church of Uganda has offices for the diocese of Uganda, including a director of education. Another interesting meeting, then a walk around the hundred-year-old cathedral and the sobering gravestones of the missionaries and Ugandan believers whose lives were spent to establish churches, hospitals, and schools more than a century before. Gives one perspective. By this time I knew I was starving Tim, but he was good natured and kept going on a few bites of samosa and a bottle of water. Next stop, the EGPAF country offices, where the early report had been that we would not only fail to receive medicines for our patients, but due to some clerical misunderstandings the funding expected for closing out the project as we transition to Ministry of Health leadership, was cut off. Needless to say the prospect of returning to Bundi 20K dollars short of expected funds and empty-handed of medicines was not appealing. After an unsuccessful morning meeting there, Scott had left to run other errands and plead for prayer and planned to return in the aftenoon. Mercy preceded us, so that by the time we met up there about 3 pm the person whom we needed to see returned for the first time to work from two weeks of being sick . . . and the director looked upon us with favor, so that the whole situation was turned around and we left with at least a temporary supply of two of the three medicines we needed, and a plan to recover the funds. Scott had filled the back seat with groceries, and so by 5 pm the three of us were heading back to the ARA together, celebrating God's care in allowing us to advocate and bless the people He has called us to serve. Now if we can just work out a funny click and play in the steering column, we could pack up and head back to Bundibugyo today . . .

A Weekend Off

A weekend off . . . perhaps seems ill-timed in the midst of
desperation. We are grateful for those who have written and called in
support of the AIDS-drug crisis. Lots of foot-work and phone-work on
Thursday we hope will pay off by Monday, as we have appealed for a
portion of the limited supplies. Not a long-term solution, but still
hopeful.

But a mercy of God is that with a kid at RVA, we take a mid-term
breath-catching pause. From Friday to Sunday this week we are a
family first and only, putting aside worries about patients and
robbers and polio and funding and the future. Our job, for the
weekend, is to be with our kids. And they're a pretty fun group to be
with. This is what they like to do: play ping pong and tennis and
soccer, swim and read novels, watch Mythbusters and World Cup Football
qualifiers, eat Thai, Indian, and Italian food, catch a movie in the
theatre, laugh at Calvin and Hobbes jokes, jump on the trampoline, and
read some more. And talk, about schools and travel and people and
chaos and God. It's a welcome break from the day to day reality of
Bundibugyo. We are usually on the move, heading to a conference, a
meeting, or at least a game park when we're on a school break. This
weekend we're just in Kampala, impersonating a normal American
expatriate family going to restaurants and relaxing. It's been great.

And we're back at the ARA (the American Recreation Association), a
place where we have history, where some of the same staff watched
these same teenagers when they were toddlers learning to walk and
later to swim. This is the very room where we landed to recover from
rebel attack in 1997 without a single change of clothes to our name,
where the managers let us rustle through the lost and found. Year by
year as Bundibugyo became home, the ARA also reminded us that we're
still Americans, too, who like a hamburger and a room with a fan. It
has been a safe place to escape into order, a place of respite.
Sometimes all the more frustrating for the illusion of American-ness
without the reality, sometimes a disconcerting dose of parallel
universes of rich and poor . . . but mostly a great escape.

So we're thankful for the weekend off, storing up the memories and the
resilience to hit the ground running again on Monday.

On heaviness and enlargement

My soul melts from heaviness

Strengthen me according to your word . . ..

I will run the course of Your commandments,

For you shall enlarge my heart.

These verses from Psalm 119 (28, 32) jumped off the page for me this morning.  My soul is dragging.  Some burdens are part of the territory of love, loving kids who cry when their heels hurt, loving team mates who struggle with the negative aspects of this culture's intrusive neediness and manipulation, loving patients who can not get the medicine they need, loving a piece of this earth that has been scarred so deeply by evil.  Some of the burdens are part of the territory of sin, wanting to fix things my way (phone calls and letters to newspapers can be good, but underneath I know my own heart is not fully right), the weight of self-righteousness and self-justification that has to be uprooted daily.  And some of the heaviness comes from not knowing the territory well enough to distinguish WHERE the heaviness comes from or how to lift it. So Psalm 119 offers this:  the concrete truth of God's word, brought into our souls to enlarge them.  Truth leading to expansion.  It would be easier to protect my heart than to enlarge it, and the temptation is strong.  Sometimes I don't even want to make eye contact with a parent of yet another child teetering on the edge of survival.  And there is a legitimate limit to the pain I can absorb, and a God-given command to rest and refresh, so I am looking forward to a weekend of respite in Kampala with kids.  However I would also pray for a large-heartedness that comes back from the rest to embrace the battle once again.

CRISIS - NO AIDS DRUGS!!

Today I saw 6-year-old Anita, who has been my patient since birth. She was one of the first children started on ARV's (antiretroviral drugs) in our clinic, and responded wonderfully. Her CD4 counts are excellent, her mother caring and faithful. She does not miss appointments or forget to take medicines. She is exactly who USAID, EGPAF, Uganda MOH, JCRC, Baylor, etc. etc. labor to save, and infant who would likely have died by now but instead turned into a growing normal-looking girl. And up until today, she represented the way things are supposed to work. But today, there was not ONE SINGLE antiretroviral pill in our clinic, or in any other clinic in the district. We've watched the supply dwindle. We've made reports, follow-up phone calls. We've switched regimens to economize and use every possible pill. We've been told to ration, to not start any new patients on drugs, to be patient ourselves, to hang on because the supplies are coming. But they never did. The margin has long been tenuous, but the shocking truth is that today dozens of clients left the hospital without medicine. By next week half of the hundreds of people on ARV's in Bundibugyo will be off therapy. And even more shocking: a phone call to Kampala confirmed that this is a nation-wide stock-out of drugs. What happens in the world if one of the countries with the highest number of AIDS patients, one of the places were the epidemic began and gathered momentum, suddenly takes thousands and thousands of patients off meds? In the short term, some people who were barely surviving, early on therapy, will die. In the long run, it sounds like the perfect scenario for a drug-resistance nightmare. I sat outside our clinic in the hot sunshine after my phone calls, crying. Crying for Anita, for injustice, for the inefficiency and poverty and poor management that led us to this point, crying for my own frustration of impotence to do anything about it (these drugs are tightly controlled and not available to just run out to the store and buy). So at least I will give voice to the Anitas of Uganda.

on police and providence

Having spent a cumulative 3 to 4 hours at the police post in the last 24 . . . I've had some time to observe and reflect.  My purpose for being there was to support our younger missionaries and national staff friends as they filed their testimonies in regards to the two house break-ins in May.  The first day we were met by a tall thin older man who was teasing and brusque and craftily bordering on hostile.  But we greeted and sat patiently, adding our smoothing friction to benches worn smooth and shiny over the years of use.  While Heidi spoke slowly and concretely so that a subordinate could write out on an official form just what was taken from her house, and just how she found it . . I chatted with the in-charge.  We had invited him to a community security meeting last week and though he did not come, the gesture served us well.  We left with assurances of concern and action and official file numbers.  However they needed one more testimony, that of a mission house-worker who initially found the second breech and reported it to us.  However, when this young man compliantly reported to give his statement this morning, he was promptly arrested.

This is the dilemma:  complying with a system of justice that involves the slow and questionable process of local law, or giving up on reporting crime altogether?  No wonder lots of people opt for the latter.  We had no suspicion of this man's guilt and no intention of dragging him to jail just because he was the one who was first on the crime scene when he reported for his job one morning last week.  By the time I got to the post for the second time, emotions were high, with the police angry that we missionaries were interfering with their investigation, our worker angry with being treated as a criminal (they took his shoes which seems to be part shame and part collateral), some of us angry that this police force seems impotent to investigate crime and bring justice.  Picture the station:  a bare grimy office with one desk, one chair, one bench, and one locked cabinet; a closet-sized plank partition in the corner with no windows except the gaps between the slats that serves as the holding cell (about 5 men were in there judging by the shoes, but it was eerily quiet most of the time), two women apprehended for beating up a third girl sitting on the floor in the corner, two impounded motorcycles taking up the rest of the space, and a half-dozen milling on-duty policemen.  Their general mode of operation is to sit in this office and the porch in front of it and wait for trouble to come to them.  So a disagreement over an arrest was probably one of the more interesting things to happen that day, and drew everyone's input.

But a few hours later, we walked out with our worker set free, all the statement dutifully recorded and filed, and a plan for some preliminary arrests of more likely culprits on Monday.  God's grace in calming words, and in a providential accident.  While we were waiting, and tempers were cooling, there was a sudden crashing commotion just outside the door.  I looked up to see a girl Julia's size sprawl across the road, her green dress in a tumble of limbs, as a motorcycle skidded to a stop on its side and a young man tore off running into the market-day crowd.  In an instant a handful of policemen were chasing the hit-and-run driver, another group proceeded to impound the motorcycle, and only an old lady and I seemed worried about the girl. By the time I reached her side the off-duty surly policeman from the first morning was there too, and grabbed her, though I was trying to protest, stabilizing her spine and assessing whether she was alive or dead.  She was unconscious and limp and I could not see any effort to breathe but the policeman was not releasing her . . . and the crowd was telling him to take her to the hospital (which is a half-block away).  Off he ran, and after excusing myself from our other investigation I followed to see if I could help them.

By the time I caught up with them in the hospital a minute or two later, she was crying.  I was quite relived to see she lived.  She followed commands and a cursory neurological exam and inspection of all her limbs and head did not reveal anything more than bruising lumps.  I wanted to admit her for observation because of the head trauma, but no one else was too convinced that was necessary.  It turned out the tall rough policeman was her grandfather.  By the time we all got back to the police post, we were no longer enemies but allies.  The in-charge was also thankful and cooperative (admittedly I hadn't REALLY done anything for this girl, though my time at the hospital did allow me to evaluate and write orders on a few other worrisome kids . . ).  

So . . a morning of negotiating peace, strangely facilitated by near tragedy.  The little girl sprawled on the road formed a Christ-like picture, a cross-solution to enmity.  Tired but thankful for a reasonable ending, at least to this phase of the story.

A notable family

One of "my" girls from my old CSB cell group is back in town, on holiday from nursing school. Since she is a sister/cousin to two CSB teachers, we invited them all up for Friday evening. We ate and talked and reminisced and played a hand-slapping two rounds of Speed Uno. But what struck me the most was the prayer requests they gave as we ended our evening in prayer: that hearts would truly be transformed at school; that my children would grow to be God-fearing; that God would give me wisdom to be a good father because I'm young and it is such an important job; that I would be a good wife to my husband; that I would not grow weary in serving in my job . . .These were real and important reflections of the Spirit of God on the move.

Specialization

While the modern economy seems to be predicated upon skill specialization, as noted in our post below on practical work, missionary life requires a broader set of competencies. Just this week one of our favorite quotes on this subject came up in a correspondence. We thank Alex Hartemink for pointing us to the actual author…

"A human being should be able to change a diaper, plan an invasion, butcher a hog, conn a ship, design a building, write a sonnet, balance accounts, build a wall, set a bone, comfort the dying, take orders, give orders, cooperate, act alone, solve equations, analyze a new problem, pitch manure, program a computer, cook a tasty meal, fight efficiently, die gallantly. Specialization is for insects."

--Lazarus Long (Robert Heinlein, Time Enough for Love, 1973)