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Friday, June 26, 2009

Seek Justice

The case of the little 6-year-old girl who was raped continues to gnaw at our hearts, with no resolution or arrest to date.  So when I asked Heidi what topic we should address in CME today (our weekly staff meeting), she suggested we discuss sexual abuse.  At first I was taken aback, about how to approach this . . .but I realized it was a good opportunity to allow airing of viewpoints and to integrate spiritual and medical perspectives.  

So I asked for the Spirit's guidance and began to look through my Bible to prepare, since this week should have been a primarily spiritual topic.  And I came to the story of Dinah, in Genesis 34.  Defilement of a young girl, capitulation by her father and murderous revenge by her brothers, intrigue and suspense.  It's a gripping tale but I worried it did not provide many clear answers.  Still we read it, and then discussed some questions.  Was Dinah guilty? NO, at least everyone agrees on this, which is reinforced by a very specific law in Deut 22:25-27.  Does God allow violent nonconsensual sex as a means to marriage?  NO, we all agreed here too, even though some cultures in Uganda consider this a normal means of courtship.  Was Dinah's father Jacob right to accept dowry payments to legalize the marriage after his daughter was raped?  The first two respondents said, YES.  A female clinical officer argued that now that the girl had been defiled, this was her only option for marriage, so it was better for the father to settle financially and leave her with the man.  An older male took the perspective that Jacob did:  peace in the community was more important than one particular girl's violation, and a monetary settlement that preserved community relationship was acceptable.  At this point I began to regret choosing this Bible story.  Maybe it is my own cultural bias, but Jacob's passivity mirrored too closely what was happening in real life to my patient.  

But then two more men spoke up, disagreeing.  If the father takes the dowry, then rape is accepted, and we can not allow that, they said. Once the first spoke up, almost everyone else agreed with them, that from a moral and legal and practical standpoint, rape of a young girl (or any woman) could not be condoned.  This led to good discussion about WHO is responsible to protect our children:  parents, the community, the government, the police, God.  And after some medical teaching defining sexual abuse and discussion the physical and psychosocial consequences, we came back to the case at hand.  As medical workers, what else could we do?  We had treated the girl, filled out the proper police reports, appealed for action.  Yet the assailant was seen going about his business yesterday.  It is one week since the incident, and he remains free.  And here the community of medical workers gave me hope.  They came up with a plan to write letters to various people in police and government, and even an appeal if no action is taken by next week.  We ended with Rev 21, where all tears will be wiped away, all things made new, even the mind and body of a raped 6 year old.  For the first time it made perfect satisfying sense to continue to verse 8 (I'm usually temped to stop at 6 or 7 on the God-high and not look too hard at hell in v. 8).  It is no mercy for the assailant to continue on his way without consequences; if he is not led to repent now, he faces a grim eternity.

So this afternoon I'm dispatching my missives, hoping for the proper tone of outrage and respect that will stimulate some action.  Meanwhile our sweet patient complains of pain when she walks, and restless sleep, and vague stomach aches, and waits for justice to roll down.  

Thursday, June 25, 2009

Discipline of Thanks

Today is my Birthday . . . and I am devoting this post to a few things to be thankful for, in honor of the June 25th  meditation in my devotional book. Because today was a doozy, with enough crazy vortex-of-crisis type events to make me wonder . . . including the last straw, a psychotic woman who started attacking me when I went out to see what she needed in my kitubbi (no harm done, and when she lunged for Heidi who was holding all the pizza toppings at the time I managed to deflect her).  Thankfulness opens the heart to communion with God, which I sorely need, so here goes.
+Jack and Julia, who are doing a great job of taking care of me without Scott, Luke, and Caleb here . . . pitching into chores with dog, cows, water, bikes, dishes, etc., solicitous of my Birthday happiness.  They are an amazing pair and a joy to be with.  
+Goats, which were sent home today with a variety of needy people. Picture a petite little mom with AIDS tugging at the rope of a massive white horned beast, her baby on her back, setting off for home!  Earlier I had the privilege of listening to the pre-distribution speeches, as our visitors Craig and Dick shared from the story of the abundant filling of oil for the widow, surely a closely related picture to the replenishing supply of milk these animals will provide.  As they talked I watched one of the mothers:  I had mourned with her when, in the pre-ARV pre-UNICEF era, we watched her son Dickson waste away and die.  She had no surviving children at that time, a real tragedy here.  But now she has a healthy 6 month old who tested HIV negative, and will stay that way by drinking the goat's milk provided today.  Having sat with her at Dickson's grave made it all the more sweet to see her receive life, and hope, in the form of the goat today.
+Team.  The young single crowd surprised me this morning when I slipped away to the Masso's empty house for prayer, preceding me with fresh home made muffins, and several scripture passages (including my Dad's favorite Psalm 121) written out, my favorite hymn, and flowers.  I felt very loved.  All day long people popped in and out to check on me, and then tonight put together a great cake-and-ice cream post-pizza celebration.  I'm humbled and heartened by the kind words on my cards, and the acts of service.
+Kevin home from the hospital, two weeks from death to beginning the rest of life, God's mercy.
+Cell phones, which allowed me to talk to my husband, my mother, friends in Sudan, Uganda, America.
+The USA football (soccer) team . . Ok bear with me but it was really fun to watch them beat Spain, to hang out with my son and some of the guys and enjoy a game where heart and determination beat the odds.  Hopeful for our life in general.
+Dancing:  we ended the evening with an all-out dance party, candles and a whooping bass, on the porch under the bougainvillea and a damply humid dark sky.  

Discipline of Thanks

Today is my Birthday . . . and I am devoting this post to a few things to be thankful for, in honor of the June 25th  meditation in my devotional book. Because today was a doozy, with enough crazy vortex-of-crisis type events to make me wonder . . . including the last straw, a psychotic woman who started attacking me when I went out to see what she needed in my kitubbi (no harm done, and when she lunged for Heidi who was holding all the pizza toppings at the time I managed to deflect her).  Thankfulness opens the heart to communion with God, which I sorely need, so here goes.
+Jack and Julia, who are doing a great job of taking care of me without Scott, Luke, and Caleb here . . . pitching into chores with dog, cows, water, bikes, dishes, etc., solicitous of my Birthday happiness.  They are an amazing pair and a joy to be with.  
+Goats, which were sent home today with a variety of needy people. Picture a petite little mom with AIDS tugging at the rope of a massive white horned beast, her baby on her back, setting off for home!  Earlier I had the privilege of listening to the pre-distribution speeches, as our visitors Craig and Dick shared from the story of the abundant filling of oil for the widow, surely a closely related picture to the replenishing supply of milk these animals will provide.  As they talked I watched one of the mothers:  I had mourned with her when, in the pre-ARV pre-UNICEF era, we watched her son Dickson waste away and die.  She had no surviving children at that time, a real tragedy here.  But now she has a healthy 6 month old who tested HIV negative, and will stay that way by drinking the goat's milk provided today.  Having sat with her at Dickson's grave made it all the more sweet to see her receive life, and hope, in the form of the goat today.
+Team.  The young single crowd surprised me this morning when I slipped away to the Masso's empty house for prayer, preceding me with fresh home made muffins, and several scripture passages (including my Dad's favorite Psalm 121) written out, my favorite hymn, and flowers.  I felt very loved.  All day long people popped in and out to check on me, and then tonight put together a great cake-and-ice cream post-pizza celebration.  I'm humbled and heartened by the kind words on my cards, and the acts of service.
+Kevin home from the hospital, two weeks from death to beginning the rest of life, God's mercy.
+Cell phones, which allowed me to talk to my husband, my mother, friends in Sudan, Uganda, America.
+The USA football (soccer) team . . Ok bear with me but it was really fun to watch them beat Spain, to hang out with my son and some of the guys and enjoy a game where heart and determination beat the odds.  Hopeful for our life in general.
+Dancing:  we ended the evening with an all-out dance party, candles and a whooping bass, on the porch under the bougainvillea and a damply humid dark sky.  

Wednesday, June 24, 2009

Goat-Huggers

Some college kids and grad students do tree-hugging environmentally-active politically-correct summer projects.  We in Bundibugyo have our summer interns hug goats.  Last night, in the moonless darkness about 8 or 9 pm, a large truck loaded with 49 goats arrived on the mission compound.  Lammech had gone to purchase these high-grade dairy goats from a project in central Uganda, using the funds raised by the Christmas-tree-ornament-project.  Forty-nine goats had to be wrangled to the edge of the huge flat-bed truck, which was about shoulder level for us on the ground, then enfolded in the arms of a waiting Tim, Doug, Nathan, Jack, Sarah, or a few strapping young men whose darkness melted into the dark night, then physically carried a few dozen yards through uneven paths to reach the Masso goat pens.  Some goats were sort of cute.  Some were massive males, like the size of small cows, for breeding with local goats.  These had pretty impressive curving horns and sharp hooves!  Doug, ever up for humor, kept us all laughing as he called out to John (tallying) and Lammech (wrangling) on the truck:  bring me a big one, bring it on, bring it on, I'm gonna wrestle this one . . . Pauline waited to sort them into the proper pens.  She had arranged for loads of fodder to be available, and water.  I merely held flash lights and helped people find their way around, and laughed and encouraged.  But I will treasure the images of Tim and Doug, arms outstretched, determined smiles, grabbing these big wiggling furry creatures to their chests and carrying them all the way into their pens.  It reminds me of Sunday School pictures of the Good Shepherd bringing home the 100th lamb.  And it is probably a far cry from anyone's image of an aspiring doctor, but nevertheless very Jesus-like.

Must-read

JD has posted the full story of the events of Kevin's mostly-dead collapse, and recovery.  It is a must-read.  Link to it here:  http://kwegesiya.blogspot.com/2009/06/instant-replay.html.

I think this is the first day they can really believe he is going to be OK, to go home, following the first night with the new internal defibrillator which allowed JD to sleep with some peace that if the deadly v-fib rhythm recurred, he would be automatically shocked back out of it.  This is a testimony of pain and fear and facing the ultimate loss, and of miraculous healing and community and love and provision.  Resurrection is God's favorite and essential modus operandi, so this points to Him as a real-life story of present-day power.

Monday, June 22, 2009

Divided Heart

With half my immediate family and all of my extended family out of this country . . I go through the day bouncing between thinking of tragedies like the little girl in red polka dots, and then about my loved ones far away, calculating time zones in Virginia, California, North Carolina . . .  Kevin had an automatic defibrillator surgically implanted yesterday, which sounds rather intimidating, praying it went well.  I heard that my mom had a fiasco with a dead car battery and then a claustrophobic 2 hour MRI of her back. Luke sounds great in Kenya, using his pottery class to design nose cones for the rockets he's making in AP Chem.  Scott and Caleb have had a great weekend with the Myhres of California, were warmly received by the Half Moon Bay Methodists, and yesterday soaked up renewing sunshine in a strenuous ridge-top hike and an afternoon of boogie-boarding in the surf.  And back to my loved ones here, today is Miss Ashley's birthday, and her devoted fans have been working hard on a lovely card.  By evening the shipment of 50-some goats should arrive by truck, to be given to HIV-affected families and orphaned babies.  It is the technological experience of simultaneity (not a word I'm sure) that can be jarring, interrupting our breakfast here to say goodnight to Caleb on a cell phone!

The world goes not well

First, if you are reading this as a kid less than 16, skip this post.

We know the world goes not well, but usually it is a background irritant to the illusion of success.  Today, however, the "not well" is like a punch in the gut.  On my ward, a 6 year old girl, who was raped.  A very normal looking sweet thin little girl in a red polka dot dress,  watching us all, accompanied by her pregnant mother and harried father.  Seems she and her two siblings were in the family's gardens alone (not so shocking, mom was tired, told them to go play after lunch) when an old man, a former UPDF soldier, grabbed her, told the other kids not to scream or he would find them and shoot them . . . and then proceeded to hold the little 6 year old girl down and rape her.  The siblings ran home crying, having recognized the man as an uncle of their neighbors, and the family brought the little girl bleeding profusely to the hospital.  This happened over the weekend, but even today the evidence of the trauma is quite clear on exam.  

How do I as a pediatrician react to this?  Shock and horror and outrage and anger.  Then some action, paltry probably.  Most importantly to let the little girl tell me her story, again, figuring that another adult taking it seriously and letter her vent is a good thing.  She spilled it out rapidly, concretely, matter-of-fact, not emotional.  Then to tell her in very clear terms this is not her fault, she did nothing wrong, she did not deserve this, she has nothing to hide or be ashamed of.  And to promise that we and her parents will make every effort to protect her.  Then to get her started on HIV-post-exposure prophylaxis (which thanks to our trip to EGPAF two weeks ago, I actually HAD in the medicine store, thank God).  The soldier connection is worrisome, and there is a belief that sex with a virgin can cure AIDS, so it could have been part of the motivation for the attack.  And treatment for syphilis.  And calling the child welfare officer attached to the town council.  And filling out the blank police report form.  And then, at last, marching to the police station myself with Heidi and the nurse and the father, to discuss the plan to apprehend the perpetrator.  It is actually unimaginable to me that no one has taken any action yet.  Fear?  Reluctance to get involved?  Hope for a cash settlement?  Apathy?  Or just lack of transport?  In this country the police sort of wait in their office for the family to do the real work of finding the criminal.  I put down a good chunk of money to try and spur on some action.

Last week our worker Saulo's family went into a frenzy of panic when their little girl, Nightie (?age 4ish) was missing from her nap.  They searched and found her a few minutes from home, left lying by the river, with a story that a man speaking Luganda had entered the house and picked her up while she slept, then threatened her not to scream . . not clear why he set her down, but he did, and she was unharmed.  There is a lot of press right now about child sacrifice, about unscrupulous and greedy people taking children to witch doctors for sacrifice to ensure success in business.  It is always attributed to "outsiders", someone from another tribe.  There is also an idea that only an un-scarred child will be used, so a circumcised boy, or a girl with pierced ears is safer.  This is driving earlier and earlier circumcision, the culture is abandoning the historical traditions of near-adolescent group-enculturation and ceremonial circumcision, in favor of protecting their toddlers.  And the day after this scare, Nightie and her sisters had their ears pierced.

When children are used by adults as sacrifices for their success, healing, or need for power . . . we know that the world goes not well.  We have a visiting pastor, Craig, from the Mariner's Church in Annapolis which supports the Pierces.  He read us the Lazarus story last night and spoke on the verse "Jesus wept".  This, he said, is God's continual posture towards the broken world.  He weeps.  Even knowing that resurrection is imminent, knowing that the Kingdom comes, does not erase the pain of wounded love for His children.  He is not indifferent, and He is actively reclaiming the territory of grief, with tears that become springs in the desert, that transform suffering into blessing.  Hard to see that today, but we hold onto the truth and pray for the Kingdom.

Sunday, June 21, 2009

Shaking it up at church

Our church service this morning was, shall we say, LONG. I think it
comes of a cultural need for participation. Multiple choirs, multiple
songs per choir . . but also in the prayer requests, there are just a
LOT of people sick or with problems they want to share and pray
about. As community grows and deepens, it takes time. Musunguzi
preached powerfully as usual, from Acts, challenging each member to
share the Gospel themselves. As he said, Dan Herron and Alan Lee came
here in 1986 and sat in Alinga's kitubbi and told us about Jesus. Are
they here now? No, but they don't need to be, because they taught all
of us. It was a great illustration of the way Paul and Barnabas
planted churches in Acts 14, and a sweet look back on our
predecessors. Later he also said, you only heard the gospel because
those men came far from their homes out of love for us, and that is
why missionaries are still here among us, they love our people. A
soothing moment for my frazzled missionary heart . . .

But the real excitement in church today was an earthquake. It sounded
like an explosion, the whole church shook, everyone jumped up from
their benches and looked around, then a few seconds later there was
another less intense rumble and shaking. Many of the congregation ran
outside. I made my kids go. It is the prudent thing in an earthquake
to NOT be in the only building for miles around that is large enough
to kill people if it falls. I know Paul did an excellent
construction job, but I'd rather observe the strength of the walls
from the outside . . . However nothing fell down and everyone hugged
and laughed to cover their fear, including me. Then we came back
inside and sang two vigorous praise songs. The danger energized the
service, and the preacher later used it to illustrate the nearness of
Jesus' coming and the importance of standing for Him.

Saturday, June 20, 2009

On feasting and fighting

With Scott gone, leading team Bible study fell to me, and as always the process of spending the week in John 2 made it way more meaningful to me than to anyone else I'm sure.  It is a fascinating picture of the announcement of Jesus' ministry:  first, he rescues a wedding party by lavishly transforming water meant for ceremonial cleansing into fantastic wine.  Then he whips the chaos out of the temple courts so that the Gentiles can regain their access to worship.  Hard to imagine an mission or NGO with a similar ministry-launch, a combination of alcohol and fury, feasting and fighting, joy and judgement.  But if Jesus is to invite us into the final wedding feast of the Lamb (Rev 19) there are battles to be fought, because we live in a world gone awry, surrounded by enemies.  And the deeper symbolism only becomes apparent later, when the passover cup of wine turns into a true consuming of God's wrath, when Jesus' blood flows for the final cleansing and making of all things new.  In that moment we see wine and joy and pain and sorrow and wrath and judgment all come together in one action, LOVE.  In Skip Ryan's book on the Gospel of John I found this poem, which beautifully combines the images:

The Agony (George Herbert, 17th century poet)

He who knows not love,
Let him take and taste that juice
Which on the cross a nail against a beam did loose.

Then let him say, if he did ever taste the like,
Love is that liqueur, sweet and so divine,
Which my God tastes as blood, and I as wine.

Do, Love, Walk

My desk is awash with papers and books that need attention, my kids
are working on homework projects and want advice, many flagged emails
and things to think about, without even coming to the food shopping
and planning and cleaning and normal home organizing that has to
happen on a Saturday, the only day in the week I usually spend focused
on life survival. So when I finally sat down to work and there was an
immediate knock on the door as Julia called "mom, someone's in the
kitubbi" my heart sank. Part of the stress of being home alone is the
no-sharing of dealing with anything. But as I walked to the door, the
ipod (on blast volume I might add) was playing a Stephen Curtis
Chapman oldie: Do justice, love mercy, walk humbly with your God. A
well-timed attitude check from a musical Micah 6:8.

In the kitubbi, two anxious parents and one very dehydrated baby. No,
they had not gone through proper channels of being referred from the
hospital. But I had seen them there during an admission less than
three weeks ago, so when the baby became seriously ill again they went
straight to the place they hoped to get help. And while part of me
wants to create protective rules for my Saturday survival, thanks to
the music in my head I was able to see them with empathy. If my baby
looked like that you better believe I'd do whatever it took to get
attention. The dad's dress indicated a different world religion, but
that is no barrier when a child's life is at stake, and I'm glad for
that, that justice and mercy offered in a humble way cross barriers of
faith and culture.

On Friday, at the "launch and lunch" celebrating the end of our week-
long Village Health Team training on nutrition in HIV/AIDS, I walked
in late just as John was graciously covering for me, and found myself
immediately invited to speak. The first thing that came to mind was
Isaiah 58, so I read a few of my favorite verses, and found that
though I was preaching to the VHT's the Spirit was speaking to ME. If
you extend your soul, pour yourself out, on behalf of the needy and
hungry . . . then God will be your guard, He will come to your aid.
As volunteers these health workers will pay a price to help others.
But their reward is from God, and He promises to refill what they pour
out.

Today I cling to that promise, too. And to the clarity: what is
required? Just this: to do justice, to love mercy, to walk humbly
with God. This was a life verse we reflected on at my Dad's death, a
summary of the way he lived. And it provides a guide for me and for
our team. Let us pursue justice vigorously, let us live out acts of
mercy, and let us do both, not in a way that promotes ourselves or
America or World Harvest . . .but in a humble day to day walk with God.