THANKSGIVING

TNTC: that's the lab shorthand for "too numerous to count", something seen through the microscope eyepiece, usually referring to bad stuff that you don't particularly WANT to see in a body fluid. But today, it refers to blessings for which we are thankful. Too numerous to count . . . but spiritual health requires that we at least list a few which are front and center in our field of view today. So let me focus the microscope and thank God for a safe landing on our soggy airstrip a few hours ago: Luke and Caleb are home (!!!!) accompanied by Sam, Greg, and Adam, three of Luke's friends and dorm-mates whose families also live in Uganda, and released them to us for the next five days or so (none are American so celebrating Thanksgiving away from home was OK). The MAF flight was delayed, first because the commercial flight from Kenya was late, and then even more because Luke and Caleb's one and only duffel bag (they packed together) from school was misplaced by the airline (and is still missing). That delay was another item of thanks today, because a torrential, sky-darkening, earth-soaking rainstorm blew in about the time they would have been arriving had they been on time. We spent most of the morning juggling phone calls, trying to determine the safety of landing once the storm lightened, starting to set up contingencies for the boys to land elsewhere and come overland . . but in the end the pilot decided to give it a go (later he said it was actually much worse than last week's monsoon that nearly derailed Barb's travel plans . . ). It was a difficult landing, with mud spraying and wheels skidding, but all's well that ends well. It is GREAT to have them home.

Once they hit the ground (literally) I left Julia in charge of lunch for 9 teenage boys (mine, visitors, and a handful of friends from here who were waiting to welcome Luke and Caleb home) and rejoined another Thanksgiving. Today was the last day of the year for Christ School Bundibugyo! We celebrate a year completed, with all its sorrows, victories, memories, stresses. The Pierces generously decided to buy all the students a logo-T-shirt which Scott ended up working on designing and procuring. It was a lovely gesture, everyone was thrilled with their shirt and the school was awash in green, the color of Bundibugyo really, of life and leaves, banana trees and rice crops. This was also the end of the Scripture Union crusade, three days and evenings of worship, Bible teaching, and prayer. Scott was the last speaker, on the Kingdom of God, or how being a Christian impacts development. This is the essence of the school vision: reaching a generation of young people spiritually and intellectually to equip them to transform this district! Along with his teaching there were numerous choirs, and David and Annelise also gave words of farewell and blessing and encouragement to the students. We thank God for the Pierces and the life they have poured into CSB in the two years they have carried the burden of leadership there. Tonight we will recognize them more fully with a party for all the staff and team down at the school, an opportunity to give God glory for these years together.

And we thank God for Deus, the new head-teacher. He spoke briefly to the students today, too, generating immediate connection, and respect. He told them that this was the school he had always wanted to lead, and that God had put him on earth for this purpose. It was very encouraging as we face the grief of the Pierce departure and all the uncertainty a leadership transition involves.

I'm thankful for my courageous husband, my loyal kids, my persevering friends. For patients who gain strength, for toddlers who regain their smile. For the prayers which sustain us. For a family that loves us from afar. For the privilege of standing for the Kingdom in this place. For the hope that it will, one day, come.

A Proverbs 31 Woman

Today marked the end-of-year celebration for Alpha Nursery and Primary School, the project Melen Musoki, wife of the late Dr. Jonah Kule, started in Nyahuka. Let me say that we've paid a lot of school fees and made a lot of loans for projects and businesses in the last 16 years, but none have had this kind of return. When Jonah was in medical school, Melen approached me to see if we would be willing to help her become certified as a nursery school teacher, since she was in Kampala with him. It seemed like a great combination, doctor and teacher, and a relatively simple upgrade to her high school diploma. She finished the course and got experience working in the city before he graduated, and when the family moved back to Nyahuka she asked for one more thing: a very modest start-up fund to establish her school. Scott's parents invested, mostly to get the uniforms, signs, and minimal equipment to convince parents to enroll the first class. Since then she's taken the ball and run with it, through the death of her husband, through delivering their last child as a single mom, through being stolen from by extended family members, through tedious bureaucratic hoops, through sending three daughters to boarding school, through untold difficulties.

Today about 130 happy children, in their smart blue uniforms, performed songs and speeches for their parents. These kids range in age from about 3 to 8 years old, three "levels" of preschool/kindergarten and two classes of primary school. Scores of beaming parents watched from their benches, decked out in their best. Recently completed classrooms surrounded the courtyard where we sat. The "graduates" wore diminutive caps and gowns. Teachers bustled here and there, handing out colorful "files" where the students' work had been collected, or escorting classes on and off the stage area. And the quiet, unassuming presence behind it all was Melen, a maternal force of competence and care, a woman who has courageously continued in life after losing everything. I was so happy to celebrate with her today. We pray that the children who receive a firm foundation at Alpha will be our CSB entering class in the next decade!

a death and a life

Kabasunguzi Grace died.  For over three years she had held onto a tenuous life.  She came to us emaciated beyond belief one summer, febrile, dying, carried by her bewildered and desperate mom from the far reaches of the district, and when I realized she was Julia's age, I committed to fighting whatever was killing her.  We didn't exactly ever find out:  we treated her for TB, and for cerebral schistosomiasis, and we sent her to every possible referral help we could manage in Uganda (Mulago, CURE in Mbale, OURS in Mbarara).  She saw specialists, even had a CT scan of her head, which may make her one of the only people from Bundibugyo to have ever done so.  Kaba became paralyzed and blind from her disease, but with our milk and her mother's dedication her cheeks filled out and her spirits rose.  She had an infectious laugh, and a never-complaining cheerfulness.  She particularly drew out the compassion of a couple of different summers of interns:  the group who read books to her and befriended her when she was first in the hospital, and a second group that raised funds to buy her a wheel chair so she could be wheeled into a school room and listen even though she could not see.  I used to go visit her on bike rides with Bethany or Kim, because SHE ministered to US.  I have to confess that in recent months I had not seen her.  It seems she and her mom had migrated back over the border into Congo.

But over the last few days I've been getting repeated calls from an unknown number.  If I answered, the person would begin to talk, but not understand me in Lubwisi or English, and would not talk back.  I sent text messages asking who it was, but no reply.  I figured it was a wrong number.  Finally this morning on rounds the voice called again.  And I realized it was some patients's mother, so I gave the phone to Olupah, who finally communicated and got the story that Kaba had died.  I am touched that her mom worked so hard (even when I could not understand her!) to tell me, but I think it probably is because no one else invested in this girl and made her feel her own care was worthwhile and important, so she wanted to share the news with someone who would also grieve.  I wish I could find her now.

Kaba only lived to be about 14.  And the last few years most people would have been appalled at the life she did live, confined to bed, in a dark room of a mud hut.  But I see beneath the failing body and bleak surroundings there was a precious little girl who had joy, affection for and from her mom, and an undemanding acceptance of life.  I pray that she is running, dancing, and looking at unbelievable splendors through resurrection eyes right now.

Six still standing

Last week I posted pictures of a handful of kids "standing in the need" of prayer. I'm sure many people ARE praying, and deserve an update.  From top to bottom:  Baluku's grandmother is smiling, as he's put on a whopping 300 grams which is a 10% increase in body weight on the formula we buy with BundiNutrition donations, AND the first drops of breast milk are appearing in her breasts in response to his starvation-eager sucking. in spite of the fact that the last and only baby she nursed was 14 years ago, the teenage mom who just died.  Bhitigale just left my house a few minutes ago, we were able to get him a slot for surgical drainage of his infected knee joints, and he's on his way to Bundibugyo. Nyangoma and Kato both reached their target weights today (!!) but are still weak and floppy-toned, and need a major social-work plan for discharge.  The preemie went home today with her delighted mom, the smallest baby yet to survive in our care.  Spice, and her colleague Birungi Chris, are smiling and drinking their milk and taking their medicines, inching their way towards a longer survival in spite of their eventually-fatal disease (maybe they'll outlive some of us).  And ScottWill shouldered at least half the burden of the day, and Nathan got a kid to at least NOT CRY when we examined him by giving him a car, so all in all many signs of mercy.

No Condemnation

Coming home was NOT EASY, though I'm glad to be here, the relief of the two days away seems elusive.  Tears are coming easily.  Holding on is coming, but not so easily.  I missed Luke's first-ever-concert, singing in the RVA choir on Saturday, which he thoroughly enjoyed.  We're dialoguing daily about college apps.  Parenting from afar feels hard.  Sarah and the Pierces begin to count down their last weeks and months, and the end-of-year events mount.  Last night we attended the CSB staff party, which was a pleasant outdoor affair with the requisite speeches, malfunctioning sound system, stunning dresses, and good bountiful Ugandan food.  Team calendars are out, planning ahead, and the reality of change looms.  Assusi, who has lived in our guest room the last few months, moved down to hospital housing on Sunday, good for her and good for us as we prepare for more guests ourselves, but still another grief and change.  I noticed a good bit of anxiety in the parents of a patient I was discharging today, then noticed that he had a traditional twin name . . . only to learn that these two parents before me had brought TWO babies to be admitted late last week, but one twin died within the first few hours.  No wonder they were worried about taking the remaining twin home.  My easy tears almost flooded again.

I had our team pray for me last week, as we process the year behind us, and I recognize my failure to make people feel as loved and affirmed as I would like.  My analogy was the poisoned ice cream I distributed last month:  I was trying to bless our team and ended up sending everyone into spasms of deathly diarrhea!  In the same way I have come to face my relational poison ice cream, words that are not well-chosen, or interactions that are too rushed, that communicate pain.  I have grieved that, and struggle how to be Jesus-like in speaking the truth in love, with everyone from my own kids to the nurse who did not show up for work on Saturday.  I thought about staying home from church yesterday, but went on faith that God meets us in the community of believers.  

The second reading was from Romans 8:  who can bring any charge?  There is therefore now no condemnation. . . .  Once again the words brought me up short, because I've been feeling a LOT of condemnation.  Grace, a nice word, a pleasant concept to talk about, when you don't feel like you need it.  But the whole point of grace is that I DO need it.  Making mistakes, speaking too quickly, failing to love, missing choir concerts, saying goodbyes, looking ahead to a year with huge question marks,  in all of these things God's grace covers me, and all of us here.

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.