Ecstasy to Agony

For 48 hours, we stepped out of normal life into the parallel universe of beauty and wholeness. A lovely setting, quiet, a cabin-like porch overlooking forest, delicious food served just to us, a small pool for dipping in to cool off, good books, conversation, sleep, stars, exotic birds, a family of colobus monkeys performing in the tree-tops right outside our tent much of the day, more sleep, prayer.  I was actually reading a book called "Eat, Pray, Love" which pretty much sums up the get-away.  God put us in bodies that need the balance of sabbath, that celebrate pleasure, that inhabit the infinite.  Being human, we need the step away from Bundibugyo to think about more than how to pull together another meal or treat another patient or weather another storm.  These 48 hours provided just what we needed with God and with each other.  

As we pulled out of the gate to drive back, however, we lost Paradise pretty rapidly.  A military armored car pulled off the road ahead of us and pointed guns in our direction.  We were 90% sure they were the good guys, but it was unnerving until they waved back all smiles.  Half an hour later we pulled up to the T-intersection in Karagutu, the only stop and turn on the 2 1/2 hour journey home.  Or so we thought.  As we rolled right smack into the middle of the intersection, the engine died as the clutch failed.  There we sat, at 2 pm, still 2 hours from home, with gears totally locked up.  But one of the only people we know in Karagutu was at our window in under thirty seconds, followed by the town mechanic whom he vouched for.  The town mechanic was about 25, chiseled, muscular, fierce looking, with a bundle of wrenches wrapped in shredded rubber tied to the waist of his tight black jeans.  He dove right under the car and came up covered in sandy dirt, confident he could fix the problem.  An angel?  So we hoped, though his general demeanor made him look a little mentally unstable.  Until the real town crazy man began harassing us, poking me with his finger and waving his arms and dancing around our car, at which point the mechanic began to seem sort of sane.  I had been waiting to get through town for a more secluded bathroom break so I was not so comfortable as we watched in the hot sun, hood open, umpteen people telling us as if we didn't know that our car was in the road and should be pulled off (we couldn't because it was jammed in gear and could not move into neutral), feeling helpless, at the mercy of a man who could have been sent from God - or not.

Communication was tough.  Scott called our usual mechanic in Kampala to have him talk in Luganda to the Rutoro-speaking mechanic.  They seemed to have a plan.  More people gathered.  The sun beat down, the crazy man orbited, the cars beeped their horns and threw up dust, the clutch slave cylinder was dismantled and re-assembled, more brake fluid was decanted into various holes.  No change.  More truck drivers came over to advise.  We repeated the whole process.  Our Kampala mechanic friend was no longer answering his phone.  It was now an hour and a half since we had stopped.  My bladder was in pain.  Paradise was becoming a distant memory.  Scott called our friend Atwoki in Fort Portal, again to have him talk to the bizarre mechanic who was glaring at us.  After they talked, he took the phone back:  "Dr., I am coming to rescue you," our dear friend said.

Coming, that is, in the loosest sense of the word.  I found a latrine.  We bought cell phone air time.  We sat in the middle of the intersection.  We met a group of pastors coming out of a conference who all wanted to greet us, and ascertain the extent of our mechanical failures as they weighed whether it was worth hanging about hoping for a free ride.  They hovered, then gave up.  We chatted with the RDC who passed by on his way to "the war office", trailed by armed soldiers.  An old man from Bundibugyo came up to get medical advice about his son.  The corn-roasting stand across the road began blaring a scratchy radio replay of a fight, which went on forever.  We sat in the car, stood by the car, waited.  For about 3 more hours.  When you're in need of rescue you can't rush things.  The local mechanic perched himself on the front bumper, and then we realized that the bag of green leaves he was carrying was not the local spinach equivalent that he was taking home for dinner, even though he looked like Pop-eye.  It was khat, a drug, he was chewing.  That explains a lot.  In the end he was reasonably competent, but high.

Atwoki was a welcome sight at dusk, breezing into town with his three side-kick mechanic buddies, all wearing their "Stitch and Sew" (the name of his mechanic shop) red uniforms.  They pounced on the problem all at once, replacing both cylinders which are clutch related.  No change.  Now it was dark, and they did the whole process again using my tiny pocket flashlight and the little illumination on their "ka-torchi" cell phones.  It was pitch dark, a wind picked up, and then rain.  For another two hours they tried.  Each failure seemed to make Atwoki more sure of just where the problem lay, but it was now 9 pm, and the next step he estimated would take 4-5 hours, removing the entire gear box to get at some sort of clutch plate, which would have to be replaced by a spare, from Kampala.  On a brighter note, he did manage to get he car to start in gear and pop out into neutral, so we could tow it off the road to the police station.  It was now 7 1/2 hours since we embarked on our short journey, we were wet, no one had eaten dinner, and our car was immobilized at the police station.  Atwoki told us to get in his car, so we did.  We thought we were all heading back to Fort Portal, but no, he had decided that since he had to come to Bundi for another errand anyway (Pat's broken car), he'd just drive us there now.

And so for the first time in our long history here we broke all our don't-travel-after-dark rules and got home before midnight.  Our gracious team prepared mattresses and food for the Stitch-and-Sew crew of four, and we slipped into our own house where Ashley had waited with the kids.  All the way we had talked to Atwoki, about our kids, his kids, fellow-missionary friends, farming, the church, preaching, cows, and memories.  We actually have more in common with our Fort Portal mechanic friend than with most other people in this world. I laughed when Scott was telling a story about an old Herron truck, and Atwoki came up with the license plate from almost two decades ago, "Oh you mean UPO-426?"  

It was a full-circle experience, actually.  The morning we first landed in Uganda in 1993, all our team mates were sick and unable to meet us at the airport.  We really didn't have much communication in those days, so we sat on the curb in the dawn, hoping someone would remember us, with the sinking realization that we had no idea where to go or what to do.  For what seemed like hours, though it was probably less than two.  As we were about to give up, Atwoki came driving up in that Herron truck, good old UPO-426, apologizing for being late.  It was our first time to be rescued by him, and yesterday probably won't be our last.

Ten hours of agony did not fully erase 48 hours of paradise.  But since our disaster motorcycle ride to this get-away a couple of years ago, and the all-spares-tires-deflated, stranded-on-the mountain return trip from this same outing last year, we are a bit wary.  Paradise has a high price.

Heading out, the luxury of wilderness

Tomorrow morning Scott and I will head out to the north end of our
district, into the game reserve where we have been granted two nights
as the guests of the managers of a luxury tented safari camp. This is
about the 4th year we've done this November overnight (though the
first time to get two nights!). It is God's good provision for our
weary souls, which are about as weary as they've ever been. 2009 has
been a long and trying year, for many reasons of loss, transition,
conflict, pressure, work, change, grief . . . our margins are almost
non-existent, and our time as a couple apart from kids, team, and work
is even smaller. So . . .if you think of us over the next 48 hours,
pray for rest. For reflection. For refreshment. For hope. And pray
for Jack and Julia left behind to complete their week of end-of-year
exams, in the capable hands of Ashley, Sarah, and Anna, with
enchiladas on the menu.

Standing in the need

. . of prayer. I'm posting pictures from rounds this morning, because I believe that pictures lend reality to another person's life, and draw in intercession. This is Baluku. His story is a couple of posts below: 14 year old mom who died, 35 year old bereaved grandmother who is now trying to be his surrogate breastfeeder. He's also getting baby formula from us. Pray he would thrive. Bhitighale, which means "they left me behind . . ", who has spent half his sad little life in the hospital with his barely coping grandmother. If he survives to a year it will be a miracle. Twins Nyangoma and Kato, whose disengaged mother usually leaves them sitting alone in the bed, and came in near starvation. Preemie who has gone from 785 grams to 1,610 . . . a life in the balance. And lastly Spice, with mom M., whose spunk and desperation speak to me. If she can gain a little more, we'll send her with her AIDS medicines and food back to her relatives in northern Uganda. Thanks for lifting these little lives up and asking for miracles of mercy.

Healed and Healing

Below see Jennifer, smiling with her grandmother, this 9-year-old had a severe hemolytic anemia and nearly died, but 5 blood transfusions, some steroids, and a week later she's on the way home. This is Kansime, the little girl whose mother began the death-wail on Friday when she thought her daughter was dead, now smiling and sitting and ready to go home after two blood transfusions and major malaria therapy. And above, M.T. who turned out to NOT have TB, and to NOT be HIV-infected from his mom, he was just HUNGRY. He's probably within a few days of reaching his target weight and going home. So thankful. And last one happy customer, the baby I mentioned whose mom I see singing to him, and kissing him. Seems he also just needed a nutritional boost and is nearly ready to go home. Praising God for these good stories today, because bearing witness means telling the happy endings, too.

In praise of teamwork

This is my dream team. Betty, who is a nursing aid but also a grandmother, knows everyone and everything about this place. Heidi, enough said, my can't-do-without person. Balyejukia, back from nursing school, competent and compassionate, a go-the-exra-mile man. Agnes, a woman of God who personifies Proverbs 31, abandoned by her husband, living far from her home district, responsible and capable. Assusi, nursing officer, completely trustworthy in clinical judgment AND personal character. Olupa, cheerful, hard-working, just back from maternity leave, wonderful to work with. I can't believe all six of them happened to intersect. If this could happen every day I have no doubt we'd be nearly in Heaven. Scott Will, who never complains, so thankful to be sharing the burden of patient care with him. Ndyezika, in the lab, saving lives by identifying malaria parasites and cross-matching blood for transfusions. Baguma Charles, heading out to one of the outpatient BBB sites with locally-produced gnut-soy-moringa leaf paste to be distributed to malnourished kids. Nathan should be in this picture too, but I missed him this morning. Loren, Salim, and Costa registering dozens of new pregnant ladies for antenatal care. All of these snaps are from the last hour or so, and as I look over them I am deeply grateful for those God has called alongside us to work here.

More witness on Friday

Tears were shed Friday, at the health center. As soon as we arrived in the early morning we found a child with severe malaria, who nearly died on us. Heidi and I were just trying to do weights on all the kids before our staff meeting, but when this child was laid on the scale we saw she was limp and barely conscious. We sent them into the treatment room where within a minute the mom began a death wail. But she was not really quite dead, yet, and when Heidi injected her with medicine she cried a bit. Six of us (half the staff eventually passed through the treatment room, though Heidi and I struggled alone at first) tried about a dozen different places to get IV access on this child, before one of the way-more-competent-than-I Ugandan nurses managed a line. Her hemoglobin came back: 3 gm/dl, and many malaria parasites. No wonder she was barely alive. With immediate transfusion and treatment I'm hoping she pulls through, an otherwise beautiful and normal little two-year-old whose family mobilized as soon as they realized the dose of medicine they had given her from home the day before was not enough.

Later more tears, quiet ones, not the dramatic "help me right now" wail from the first case, but the seeping of tears from a broken heart. This time we were trying to understand why the 3 month old baby in front of us was so malnourished (breastfed infants tend to thrive the first few months). The woman I took to be her mother was, it turns out, her 35-year-old grandmother. The 14-year-old mother of the baby had died last week, after a 2 month hospitalization elsewhere. The story does not hang together very well, but we were told that the 14-year-old mom had an "intestinal problem" a month after delivery, required surgery, and that her surgical wound became infected. Tragic in every way. More tragic as her mother, sitting with the malnourished grandchild, related that the dead daughter was her only child. This is what our motherless-baby program is all about: helping this grandmother save this baby.

Meanwhile the 785-gram preemie doubled in the last month to reach 1.5 kg (!). A child whose desperate parents had taken him out to a "witch- doctor" when he did not immediately improve and then come back when he became even worse, whom we prayed over in Jesus' name with only a grain of faith on Monday . . went home, cured. Three children in three consecutive beds each had 5 units of blood last week: one with sickle cell and two with unexplained hemolytic anemias. After losing two children with similar symptoms the week before, we rejoiced to reach Friday with all alive and improving. The women whose stories I told a few days ago are hanging in there, no dramatic resolutions, but at least stabilizing. Caught another mom playing a singing a game with her baby who has begun to round out on UNICEF milk.

The week ends, with some tears, and some signs of tears redeemed, of effort and prayer and struggle resulting in healing.

perfection x perfection

My man reaches a milestone of Biblical proportions today, 7 x 7 . . . a number that represents completeness x godliness. I've known Scott 29 of those 49 years, and been married to him for over 22 of them. So at the risk of causing embarrassment or losing my blog access privileges, I will bear witness. One of my favorite books is The Time Traveler's Wife, because it takes a human relationship above the vagaries of time, and shows that the person we are becoming is part of all that happens along the way. Embedded in time, however, we can look backwards with thankfulness, but only forward by faith. On such a milestone as this I look back to say the years have forged a man of integrity, grit, humility, strength, and love. One who can doctor a cow or a person, fix a motorcycle or a computer, read a novel or a sports page, teach about the Bible or AIDS, score a soccer goal or bake a pizza (and usually all of that in the same week). Each year only increases my confidence in his judgement and gratefulness for his patience as father of my children, lover, friend. So today I look forward by faith for all that is not yet seen in the next 49 years. Having survived loss of loved ones, rebel war, ebola, and more importantly the daily wearing challenge of life in a broken world among other sinners such as ourselves . . . I am not afraid of what comes next, with him.

Note that according to Leviticus 25, we should be due for a year of Jubilee: sound the trumpets, proclaim liberty, return to family, and dine on the holy grain and grapes. Sounds like an HMA?

You say hello, goodbye

Anna Linhart arrived almost two weeks ago, and already feels like a very integral part of our team. Pray for her to really engage in language learning and cross-cultural friendship even as she finds her feet in ministry with our kids as a teacher at RMS, and with the CSB orphan sponsorship program.

Scott Will, otherwise known as Superman, has been here for a month, working as a physician assistant at the health center, and reaching out to neighborhood kids. And just being an all-around voice of cheer and sanity and passion for God. He is committed to Mundri, Sudan, but in a clever deal negotiated in the smoky inner board rooms of WHM, we get him until the end of January.

Today Dan Thrush departed after a one-month rotation as a Physician Assistant student, half of that time accompanied by his wife Karen who is a marriage and family therapist and did play therapy with the kids on the ward. We are not-so-subtly praying and begging that they come back to Africa with WHM after finishing school.

Barb Ryan landed on the airstrip a few hours ago, and has a week-long agenda of love. She has come in a pastoral care capacity to listen and counsel and re-connect with us, after spending a month here last year with her husband Skip.

The Massos landed for an interlude from Sudan . . . Karen and kids now, Michael to join soon. This is an opportunity for some closure before the Pierces move on next year, and gives time for organizing their old house for the Johnsons to move in (we hope by January). But mostly it's just great to see their familiar faces and bask in their friendship.

Women, Bearing Witness

John 12 is one of my favorite chapters, and has been a very spiritually significant one in recent years.  It opens with Mary pouring perfume on the about-to-die Jesus, an act of devotion and prophecy that his body will soon be prepared for burial.  She can't stop the march of tragic events, but she can bear witness.

So today, I bear witness to some women and their lives, unable to stop their suffering, but called to testify about it. 

This morning began with a mother and grandmother arriving somewhat breathless on the ward, carrying the bundle of Achelo Jeneti, a very sick 2-year old.  Normally patients are supposed to begin in the outpatient department, but a quick look at Jeneti and I knew she needed lots of help, fast.  It turned out that she was HIV positive, though her mother out of denial or misunderstanding had never brought her for care until today, when it was too late.  In spite of our best antibiotics, and a blood transfusion, her little body had decompensated beyond the point of return.  Jeneti's grandmother was hysterical:  of her six children, five had died, and this daughter with AIDS was her last living offspring, and had now left her without a grandchild. Jeneti's mother's wails pierced the ward, she had been abandoned long ago by the baby's father, a soldier who fled back to his home in Fort Portal when his health began to fail.  Two women who had come too late for help, and lost everything.

The ripples of AIDS are most acutely felt by the young women, the outsiders, the abandoned wives.  Two on the ward are in their late teens.  One I can picture a few years ago, full of hope and importance, sent by her father to a good school in Fort Portal. She returned pregnant by a school staff, and infected with HIV, and now her child is malnourished and struggling, as she lives back with her parents, her education suspended probably forever.  The other is from Kitgum, far away in northern Uganda.  Her parents brought her here when her soldier father was transferred this way.  Both have since died, and she has been left to survive as she can.  For a young woman in Bundibugyo, that means finding a man to pay for her needs, and giving him what he wants.  In this case she also received the HIV virus.  Her baby also has AIDS, and she spent the weekend out searching for money from any acquaintance from her tribe who would help her get to her uncles' homes up north, because there is no one here to whom she can turn.  She is right beside a listless young woman from Congo who has not seen her family home in eight years.  Her husband has refused our plea to send someone from the family to help her with her malnourished twins, and she looks tired and vacant as they whimper side by side on the bed.  

A woman's voice here is only felt if she has brothers, a father, or uncles to back it up, or a grown son to stand behind her.  Without that she is a trade-able commodity, a potential producer of more clan members for a temporary husband, easily discarded when she becomes sick or inconvenient.  Too many suffer alone, perhaps the greatest loss is to see them emotionally withdraw from a child they suspect will either die or be reclaimed by the father's family.

Our pouring of perfume is more like milk, some nourishment, a prayer, kind words, eye contact, listening.  And remembering.  And giving witness to the suffering we can't stop.

A tale of two boys

In 1993, sixteen years ago, we were fresh young missionaries (less than two months' experience) when the rest of the team left for Christmas.  And two little boys, about 11 or 12 year old, came and asked us to buy them used shoes for the holiday, little boys who had become acquainted with some of the other missionaries and therefore hoped we would be sympathetic to their needs.  One was an orphan, his father had died and his mother remarried a man who did not accept any responsibility for him, so he lived with his late-teen and somewhat mentally unstable older brother in a small hut, subsisting, and primarily taking care of his sibling.  The second was the son of a man debilitated by severe alcoholism, but a little more connected with family and clan.  Both found their ways into our hearts and lives, beginning that first Christmas and continuing through the years.  We bought paper and pens for their primary school classes, or occasionally new material for school uniforms.  When they were ready for secondary school, the orphan went into the inaugural class at CSB.  The other boy was a year or two ahead, and since CSB was not then available, we helped him get into school in Fort Portal.  

And that is where their paths diverged.  The orphan struggled academically but thrived spiritually.  He became a Christian.  He worked hard and persevered even through failure.  He completed training as a lab tech, married (in the church no less, and prior to moving in together, very rare) a lovely young woman who shared his values, and now has a sweet 7 month old baby. They were eating dinner with us this week and I was so thankful to see this young man, now in his mid-20's, has become an amazing father.  I rarely have seen a man play with his son like that here, helping him stand and walk, getting him to giggle uproariously.  God's mercy in his life is so evident, taking him from boy to man against incredible odds.

The story of the other boy has been more of a tragedy.  He was much more gifted academically, and did well enough in school to become a teacher.  But he lost his job when he was found to have had an inappropriate relationship with a student, he began to slip into his father's alcoholic patterns, he borrowed money and lost it, he floundered, he had a failed marriage and then another.  For about seven years his path has led mostly downward.  Many times we have sternly warned him, or prayed, or pleaded, or advised.  But our lives grew apart.

Today he stood up in church and told the congregation that he wanted to become a Christian.  He told about two dreams:  in the first he was sitting by the road drinking with a group of men, and people came up behind them singing.  One of the singers looked directly at him, and would not stop looking at him, so he ran away.  This dream made him feel convicted of his sin but he was still helpless, or unwilling, to leave it.  In the second dream he was crossing a flood-swollen river on a log, which began to break, and as he fell into the torrent where he could have drowned, he called on the name of Jesus, and the water dried up.  The combination of an awareness of displeasing God, and then a hope in the greater power of Jesus, led him to take the courage to stand up today.  

These two boys started in nearly the same place 16 years ago, but have taken very different paths, partly by their own choices and partly because one was the end of the pre-CSB generation and the other had six years of discipleship and oversight there.  Yet God was at work in and for both of them.  Pray particularly that the young man who professed faith today will have the power to turn away from the destructive cycle of alcoholism. He said that after giving his testimony he knew by evening that his old "friends" would be laughing at him and tempting him to rejoin his former patterns of life.  

I would love to see both young men with us, worshiping, this Christmas.