Weekend in Bundi

On Saturdays, I try to be a real mom, the kind of person who has pancakes ready when her kids wake up, who sews on missing buttons and bakes cakes and cuts hair and cheers at soccer games. I am all too aware of the many times my kids do not get my full attention, and appreciate their understanding, but on Saturdays I look for some balance. The day goes by too quickly, even with the effort to be purely domestic and ward off medical consultations and other problems. A half dozen kids who have been friends with ours for many years (well, mostly with Julia, who is the friendliest) help us finish off the leftover pizza for lunch, and then I hear raucous giggling in games of chase. This week we ended the day to slowly realize as we watched that someone who writes movie reviews has rather different ideas of comedy (which involve a dark and bloody plot, drugs, suicide attempts, organized crime . . . this is funny??). At least we could laugh at ourselves for choosing it. Oh well.

Sundays we have a big long breakfast, making cinnamon rolls and pretty amazing coffee with fresh hot steamed milk. This week we drank in Pamela and Pat's fellowship as a welcome addition to our usual crowd. Church was uncharacteristically timely, where the sermon series through Acts continues, a convicting sermon challenging us to visit each other in our homes like Paul and Silas did. We moved our weekly "family soccer" game (which usually includes our extended family of team as well) up into the heat of the afternoon to be sure we could spend that hour, which means a LOT to our kids. Then up to Bundibugyo town to visit Dr. Jonah's grave with Pamela, and reminisce about the days of ebola, painful memories but so good to share them with a fellow-mourner, and to pray for his family. We timed the visit so we could then pick up the first of our two anticipated educational consultants for CSB. As his bus came limping in at a very severely tilted angle we could glimpse the relief on his face as he waved through the window. His first words getting in the car: how did you people ever find yourselves in this place?

Yes, Bundibugyo is the end of the road, even for a middle-aged well- educated well-traveled Ugandan who has been pretty much everywhere (including America). We made brief stops at the two other biggest secondary schools in the district to help him get a context for comparing Christ School. As we approached Nyahuka, he asked again about the selection of the location, and we told a bit of how the campus had once been out of town, but due to rebel insurgency in the late 90's the town expanded massively with IDP's who never went home, and we suddenly found ourselves entrenched in a very urban landscape. His response gave us something to ponder for the evening, something like this: "Well, you're missionaries, so you want to be where people are, right? Because the big mainline denominations in Uganda historically built their churches and schools out of towns, and thereby lost their greatest chances for impact, compared to the more recent emergence of Islam which has centered itself squarely in the middle of towns. Let's think of how to take advantage of this crowded urban environment for the sake of the Gospel." Hmmm. We passed the professor off to David and returned home at dusk for a quickly concocted dinner combining anything left in our fridge, and then a fun slideshow of Scott and Caleb's America adventures.

Monday is just around the corner, with all of its attendant demands for the new week. I'm thankful for the weekend.

wholeness, again, among the saints

Pat and Pamela arrived for team meeting tonight:  Pat after 3 months in Kenya and the US on a short HMA break; Pamela after 18 months in the US working with Redeemer Presbyterian Church in NYC.  As we sang and prayed, I sensed the same wholeness that came with Scott and Caleb's return, the relieved comfort that something is back in place as it should be.  Our team relationships extend through space and time, renewable with shared memories and hugs.  We had set aside this week's team meeting to reflect on ways God was moving by prayer and partnership to invest in emerging Ugandan leadership as we work together to show the compassion of Jesus to the poorest.  Very encouraging to recount the concrete ways this vision has taken on flesh, and also challenging to pray for the next steps.  

The next month looks, well, FULL, as we pray and partner on ahead. We will enfold entirely new people into our lives for short periods of time, and we will be pursuing stability and sustainability and leadership transition in our ministries.  Scott turned in his last Kwejuna Project quarterly report; we are no longer functioning to channel the money between EGPAF and the district.  One of the nurses we sent for nutrition training is stepping up to take initiative to train other staff.  Next week the first of two consultants we hired to advise us on Christ School will arrive, a Church of Uganda-affiliated professor of education (with a PhD from University of Minnesota).  The process of praying for a Ugandan headmaster, and accountant, has already been set in motion.  In important ways we see our role changing.

Changing, but not ending.  There will still be gaps to fill.  Today I was referred a 1 year old whose nonspecific viral-crud sort of illness had left him suddenly unable to walk.  I found an otherwise healthy child with a floppy, immobile left leg, a clinical picture consistent with polio.  So that triggered a series of phone calls and forms and lab samples that will tell us if a wild-type polio virus has infiltrated once again, a sobering reminder that the battle for health still needs vigilance and effort.  At our weekly staff meeting the in-charge presented data compiled by a national survey of health facilities, and on many axes we still have miles to go, much work to do.

So tonight we pause to look soberly ahead at the road before us, and to thank God for all the saints with whom we travel this path.

Grace

The nature of grace is that it finds us when we aren't looking for it.  (Skip Ryan, That You May Believe)

Scouring the Byways

The pediatric ward is full of some pretty pitiful people, and this morning I found my hard heart wishing that it wasn't. When I bent over to examine malnourished twins and smelled the alcohol wafting up on their mother's breath, I was annoyed with her. Then there was the two-year-old with a tiny head and puffy body whose father admitted he was tired of this handicapped child who cried all the time, which explains why the kid keeps landing on our doorstep as our problem in spite of months of supplemental food (third time he's shown up for admission in six months). Another frighteningly malnourished child's grandmother started complaining that she had not brought pans with her to cook in (which everyone does) and as we talked I realized in spite of her apparent helplessness and angling for yet more assistance, there were three competent women in this girl's life, both maternal and paternal grandmothers AND HER OWN MOTHER, gathered around the bed. It seems that when her father was arrested for stealing cocoa, her mother abandoned her to the care of one grandmother, and three years later they are all suddenly realizing that the girls is inches away from death. Then there is the abandoned-to-another grandmother cerebral palsy kid whose problems already seemed pretty unsolvable, even before she also tested positive for sickle cell disease today. Or the little girl with severe malaria whose mother complained she had no mosquito net, though whenl I pointed out that it was documented on her chart that she had received two within the last year, she quickly explained those had holes in them. In short there is hardly a patient on the ward whose suffering is not in some way related to poor parental choices, marriage quarrels, neglect, substance abuse, carelessness, or just plain hard knocks in this life. And it is like there is a neon sign on the roof of the hospital, calling all of the most un-fixable problems, the most mired-in-distress families, to pour on in.

But isn't that just what Jesus would want? Sure, I'd rather invite the relatively competent, "deserving", one-concrete-medical-issue-only types into the ward, the kind of kid that gets three doses of Quinine and smiles and walks away healthy. The kind of kid that one can feel a sense of accomplishment in helping. Instead Jesus tells the story of filling his feast from the highways and the byways, pulling in those at the margins, those that have messy lives and dysfunctional relationships. Because in reality, that is who we all are. Struggling parents, making bad choices, failing to love and provide, and needing grace.

Praying for a byway-scouring heart.

Boys are Back

It has been such a relief to welcome Scott and Caleb back I did not
bother to post the good news . . . but Monday evening the big red
truck pulled into our yard, 20 days and 12 hours after it left, with
Star yelping and Jack and Julia jumping onto the running boards and me
running out to say welcome home. We had a great reunion, just the
wholeness of being back together again. As we finished cooking our
coming home feast, I realized I was SO HUNGRY, for the first time in
three weeks, the cloud of stress of surviving alone had lifted and
left me with an appetite! We laughed a lot, and opened trunks of
goodies (shoes, clothes from the grandparents, chocolate chips and
good coffee and nuts and pepperoni, a few dvd's and books, Christmas
in July). Then we called Luke on the phone and it was almost like
being a whole family again. In 10 days he'll be here, too. I'm so
thankful for my family, the best people on earth.

Semilki Forest Hike adventure, part 1

Here are Jack and Tim in front of the hot springs, an eerie area of sulfurous vents where boiling water steams up through cracks in the earth. We took the interns on a weekend camp-out in the Semiliki National Forest: hearing turacos and a flash of blue, watching monkeys chatter and drop through the trees, staring down baboons on the path, and every few minutes pulling viscious biting ants out of our skin. It was great. As the mosquitoes and dragon flies buzzed us around our campfire I told them it was an amazing thing to be sitting in what may be the epicenter of insect life on the planet! Lunch on the trail, thanking God for His creative powers and unfathomable might, and taking a break from the strenuous 7 hours of hiking and ant-battling. Julia always sticks right with the guide--nothing incongruous about a 12 year old learning to plait palm leaf fibres (used in making hats and mats) from a man in fatigues toting and automatic weapon. This board walk covers the open wetland around one of the hot springs . . the rest of the day we were in dense tropical rainforest.

Semilki Forest Hike adventure, part 2

This is the view of Congo , 10 km from our starting point . . . Not seeing any crocodiles (this is the very area where the biggest one on record was found) we went down and touched the water, then hiked 10 km back through the forest. On the way home, a peculiar clunking sound, which was not solved by a change in tires. No trip is simple here, but after extensive pondering, bolt-tightening, and a call to Scott we risked driving on home at a very slow speed (at one point I remarked that we were being passed by a butterfly). Now the Bat-mobile (aka former Bart-mobile, aka Zoolander) will wait for a mechanic to examine all the bushings and pronounce the verdict. We learned Heidi is pretty adept at popping the clutch for a roll start (the electrical system is also touchy on this vehicle, with temperamental starting and frequent random waves of the windshield wipers). Thankful to be home!

Not the end of the story

After a long game of tag in the moonlight last night, our interns, team, and kids settled down for one of our Africa-film series videos, War Dance.  This excellent documentary puts faces with the stories of three real children from Pader district in northern Uganda, and I've posted before about the power of the artistic images and the grip of the compelling story.  This time through I was struck by a short scene in which an elderly teacher who has returned from the big city, Kampala, to help this small primary school prepare for the national music competition where they will compete, stands in the front of the classroom and talks to the kids.  We've just heard one 14-year-old boy tell his story to the camera of being abducted by rebels and forced to kill a man with a hoe.  The teacher says:  Yes, you are children of war, that is part of your story . . . but it is not the end of your story.

Those words offer such hope, to the children who practice and dance and sing and prepare, who travel to Kampala and shine as they represent the Acholi people.  And they are wise words for all of us scarred by evil, our own and others.  Yes, we are children of war, children of the earth, and that is part of our story . . .but not the end.

A bit of TS Eliot

A friend sent the following stanzas from East Coker (4 Quartets).  As a wounded, dying healer I resonated with sharp compassion, and the inevitability of all our sicknesses growing worse, until Good Friday's cure is complete:

The wounded surgeon plies the steel

That questions the distempered part;

Beneath the bleeding hands we feel

The sharp compassion of the healer's art

Resolving the enigma of the fever chart.

    Our only health is the disease

If we obey the dying nurse

Whose constant care is not to please

But to remind of our, and Adam's curse,

And that, to be restored, our sickness must grow worse.

    The whole earth is our hospital

Endowed by the ruined millionaire,

Wherein, if we do well, we shall

Die of the absolute paternal care

That will not leave us, but prevents us everywhere.

    The chill ascends from feet to knees,

The fever sings in mental wires.

If to be warmed, then I must freeze

And quake in frigid purgatorial fires

Of which the flame is roses, and the smoke is briars.

    The dripping blood our only drink,

The bloody flesh our only food:

In spite of which we like to think

That we are sound, substantial flesh and blood—

Again, in spite of that, we call this Friday good.

Wednesdays . . .

Always start well, with team prayer meeting, and the opportunity to play our little keyboard piano and sing, which I love.  The last two weeks in particular, those team mates leading prayer have taken admirable risk to confess sin and ask for prayer in deep and real ways.  2 Cor 4 keeps coming up, faith, looking clearly for that which can not be seen.  

Yogurt, granola, coffee, tea, making sandwiches for lunches, checking email, thinking through the day, greeting workers and making sure they are set, gathering a few supplies to restock at the hospital, getting on bikes to head off to school and work . . .. 

Wednesdays are usually pretty full, with rounds on the over-crowded ward and then mid-day in the HIV clinic.  Today was no exception.  Sometimes the nurse coming off of night shift tells us whom she thinks is the most critically ill, so Heidi and I begin there, then proceed slowly, bed by bed.  Checking labs, counting out pills, examining, touching, talking, thinking, searching for clues, trying not to miss any important danger signs, patient after patient.  Sometimes the sheer effort of listening in another language fatigues.  I try to think about teaching staff as we go on rounds together, too, though the extra energy for that can be hard to find.  And with two interns (one pre-med and the other in med school) who are bright and questioning, I come to the end of what I know pretty quickly!  I remember why parents like to justify action with "because I said so . . ".  Sigh.  Mid-rounds I excuse myself briefly to call the District Police Chief and complain that the rapist still has not been arrested, a moment of advocacy in the midst of science.  With all the beds full a dozen or more patients are on mats on the floor, so I have to kneel or squat to examine them.  One of the last kids looks pretty comatose, but responds to pressure on his hand, opens his eyes, but does not talk.  I see him trying to focus on me, on his mom.  So I pull out a sweet, and ask if he'd like it, and he raises his eyebrows . . and I'm reminded of Kevin coming out of his coma, and smile.  This kid has severe malaria, but he'll be OK.  

Then over to the clinic for AIDS patients, which is usually bustling.  I see patients in a little side room, calling out  "onje?" (is there another?) through the curtain as I finish with each one.  As I'm tracking down a lab result, I notice one of the interns looks bored having finished weighing all the patients, and pull him in to see patients with me, more time here to discuss the complicated issues surrounding HIV-care in a resource-limited setting, something close to my heart.  We tell a mother that her baby's HIV test was negative, a joy I get to repeat twice today.  I notice that Barak Obama, who was named after our American president after being born in our truck on the way to the hospital, is also negative.  Fun.  I review the 5-years-of-growth-chart data on Mumbere, who has the ID number 4 (out of a thousand or so), one of our first HIV patients.  This is where he came starving and malnourished, this is where he got TB, this is where his mom died, this is where he began anti-retrovirals, this is where his grandmother took over his care.  Later I notice a baby whose mother coughs, a lot, and I send her for TB testing, no use to just treat the baby when his greatest risk is probably his mom's untreated infection.  In and out of the exam room, connecting some patients with peer counselors, making sure that CD4 counts are being collected, that medicines are being dispensed.  

Back to the ward, malnourished twins have arrived, a rather complicated (and in duplicate) ending to a five-hour morning  . . then notice that three of our best nurses are struggling to get an IV in a very anemic child, who is going into shock.  While they keep trying, I walk the medical student (who has EMT experience) through an intra-osseous line.  He gets it in, but we are not getting good flow, and by that time the nurses get an intra-venous line.  

Brief stop at CSB to discuss some team issues, then back home for an hour, firing off a few emails and counting out funds to send 30 blood samples for CD4 testing (has to be done in Fort Portal), with the bonus of returning with blood for transfusions from the blood bank.  Back to CSB for chapel, very optional, but an opportunity to greet a few staff and students, touch base with Jack and Julia, pray while the chaplain preaches, for heart transformation and spiritual growth and cultural change and peace at the school.  

Then cooking dinner, Jack and Julia stay for football (soccer) pick-up games with kids at school, and I'm alone for the first time since 6 a.m.  Liz from the WHM office has sent me a fantastic sermon series, so instead of the radio, I put one on as I cook, knowing I need my frazzled focus to be re-directed to Jesus.  The story is of Mary Magdalene, of looking beyond the voices in our lives which tell us who we are, to the unseen reality of what God says is true.  Again, looking clearly for that which can not be seen.  I've seen a lot of grief and anxiety and conflict and instability over the course of the day, and I realize how strongly I want to blame my stress on the situation, want to have the problems fixed my way, instead of waiting on God.

Wednesday nights are family night.  Right now that's just three of us,  but we set out our best plates and glasses and light our candles and eat our spaghetti with freshly made sauce.  I'm so thankful for this protected evening, setting ministry and other relationships aside, to listen to my kids tell about their friends, about what a teacher said or how a soccer play went.  Their lives are not always easy.  Today Jack was blatantly fouled from behind while dribbling the soccer ball, then had lots of kids jeer at him as he rode his bike alone up the road, and came home to chores and the news that he has an unexpected chemistry test at 8 in the morning.  That's a lot for an 11 year old to take.  So we talk, and call Luke, and listen to music, wash dishes, read out loud, until Wednesday fades into sleep.