Webhale Abhili na Bhisatu!

Today's traditional greeting:  thank you for the 23rd!  The festive atmosphere builds.  Markets are bustling.  People are greeting.  Bundles of food are moving from gardens to homes, or from one branch of the family to another.  Clothes are being washed and ironed.  We wandered around to all our neighbors and also branched further afield to friends, sitting, greeting, smiling, just affirming our connections.  Christmas is nearly upon us.

So in the spirit of the special nature of this week, we've been giving gifts to our patients.  Forgive me Amy and others, for not remembering a camera these last two days, as the malnourished and HIV-affected children, and those admitted with malaria and pneumonia, all received the stuffed animals, blankets, and toys that we have been saving up from your boxes for this Christmas season.  Except for one 2-year-old who was terrified by his brown furry teddy bear (keeping in mind that most of these kids' only experience with something of that size and texture would be a large live rat, and they have no mental category for a stuffed toy) . . . the gifts were immensely popular.  I looked back to see a mother stroking a toy Elmo against her cheek, and the caretakers could not keep their hands off the goodies.  The ward is only about half full, and we have only one child left on nutritional rescue . . pretty amazing for the holiday.  But the few who are there are quite ill, and I think it strengthens their parents' hearts to know that far-off strangers have made the effort to bless them.  So in spite of snake bites, coma, appendicitis, and AIDS . . there was laughter today, and this is God's will.

For behold I create Jerusalem as a rejoicing

And her people a joy.

I will rejoice in Jerusalem, 

And joy in My people;

The voice of weeping shall no longer be heard in her,

Nor the voice of crying.

(more from Isaiah 65)

And the Word became flesh . . .

Yesterday we were invited to the annual Lubwisi/Lwamba Bible Translation and Literacy Project end-of-year celebration. In many ways it is a typical Ugandan party: dressing up, siting on benches in a hot room, enduring speeches, waiting for the hugely desirable chicken stew on rice ultimate meal. But in other ways, this party is unique. In the room were a couple of dozen people, from 10 different church denominations, male and female, younger and older. As we all stood and introduced ourselves, one of the wives of a committee member was a real fireplug going on and on about how thankful she was that they were acting like bajungu and inviting WIVES to join in! And anyone who did not bring their spouse had to explain why not! Some worked to translate, others to check and approve, others to teach people to read in their own language. This is a very independent project now, and our inputs are minimal. 21 of the 27 books of the New Testament have been translated now . . which means that in 2010, we should see a full New Testament!

Scott gave a very encouraging speech to these faithful men and women. Because of them, God's glory becomes more full, more complete, as He is known in another language, one which equally reflects who He is. Because of them, the people of Bundibugyo can read for themselves what He has said and sift out the impurities of western culture that have infiltrated "Christian" practice in Africa. Scott said it was appropriate that we celebrate their project during the Christmas season, because Jesus is the WORD of God, and they, like Mary, are giving birth to the word, this time in paper and ink.

Early Thanks

A few early Christmas presents this year:  first, hugely, that a major donor who had been contemplating covering two salary positions at CSB for 2010 decided to commit to that, a gift of about fifteen thousand dollars.  We are so thankful that this man and his family put their support behind the school, a sign to us that God continues to have plans there!  Second, also hugely, that a church in the US decided to fund the Mundri, Sudan's team housing needs, appealed to a donor and came up with fifty thousand dollars for them.  They are currently living in a rented house and tents, rather squeezed.  This will allow them to complete construction on several small locally appropriate houses for the team as well as for the Bishop (see WHM Sudan "Beyond My Faith" blog link for story).  Thirdly, we've heard from a few other donors who are willing to support either nutrition or CSB, and are waiting for year-end-accounting to figure out where the need is greatest next.  And lastly, about fifty of the goat ornaments have been claimed, raising almost ten thousand dollars.  It's not too late to get one if you haven't!  We're hoping the project will get close to twenty thousand dollars to continue through 2010 (see link on our sidebar, "Give-a-Goat", which takes you to the WHM site).

All of these are specific answers to prayer,  signs of God's blessing, being given to our team, in order to bless others, which is His pattern for work in the world.  To conclude with more of Isaiah (65 this time):

They shall build houses and inhabit them;

They shall plant vineyards and eat their fruit . . 

It shall come to pass, that before they call, I will answer; 

And while they are still speaking, I will hear.

They shall not hurt of destroy in all my holy mountain,

Says the LORD.

Dreaming of a White Christmas

The news of the East Coast Snow Storm of the decade (?century) has been a bit hard to take here where dry season has begun to bake us in the oven of sunshine and dust. The only thing very white about our Christmas is us. But being a family of Scandinavian heritage (Scott's dad is of Norwegian origen, and mom Norwegian/Swedish) we have imported some of those traditions even to the equator. So yesterday the kids spent the morning cutting out the most intricate and amazing snowflakes, which we suspended from the ceiling with fishing line. Then we set up the front room for an authentic White Dinner Feast for our team. The idea in Norway I guess is to have a dinner where everything is white: fish, potatoes, bread, fruit salad covered in cream, even cauliflower as the veggie. Heidi has added in the first course cold cucumber-yoghurt soup, and everyone on the team brings some white food specialty, topped off with a coconut cake for dessert. And I give my all to the lefsa, a potato-tortilla that is rolled with butter and sugar. Scott said the table blessing that his grandfather always prayed in Norwegian. We ended the evening out on the patio with our final advent readings, focused on the theme of home, how we miss it as pilgrims and strangers on this earth, how the longing points us to our real home being prepared for us (John 14, Isaiah 25, 65, and Revelations 21).

And in this mountain

The LORD of hosts will make for all people

A feast of choice pieces

A feast of wines on the lees,

Of fat things full of marrow,

Of well-refined wines on the lees.

And He will destroy on this mountain

The surface covering cast over all people

And the veil that is spread over all nations.

He will swallow up death forever,

And the LORD GOD will wipe away tears from all faces;

The rebuke of His people

He will take away from all the earth;

For the LORD has spoken.

Waiting, in Bundibugyo, for that day, and tasting the signs that it is coming.

They shall not hurt or destroy in all My holy mountain . . .

For Behold, I create a new heavens and a new earth;

And the former shall not be remembered or come to mind.

No more shall an infant from there live but a few days . .

They shall not labor in vain,

Nor bring forth children for trouble;

For they shall be the descendants of the blessed of the LORD,

And their offspring with them.

Isaiah 65

This is Jokim, on his way home today. When he first came in weighing 3.7 kg (as a 9 month old, in the most severe category of <60% wt/length), I could not bear to photograph him, it was like exposing a dead body. He was skeletal and covered with sores. For three weeks he held onto life by a thread, and his mother held on to him. We gave milk, and started him on TB treatment. Then suddenly about ten days ago he turned a corner. He was hungry, he drank, he smiled, he grew. The transformation was astounding. Jokim is for me a first-fruit sign of the promises of the new earth, where tears are wiped away. And this Christmas season we still sorrow over the infants who die too young, who hunger, who struggle, but we take heart in this glimpse of God's healing power.

Marvelous Market

That was the pastor's description of yesterday's market: marvelous. I'm not a huge fan of shopping, but I did enjoy tagging along with Pat and Jack and entering into the excitement. Huge crowds, milling, pressing, searching. Brightly colored new clothes, made in China and India, Obama-brand jeans. Yards and yards of sequined sheer wraps, or printed cotton. Cabbages, tomatoes, flustered chickens, raw meat, sort-of-fresh fish. Piles of bargain shoes. Tin bowls. Plastic sunglasses. Everyone on the lookout for an outfit and food they can afford to make the day special. And then, shockingly, a marching band, brass and drums, striding through the chaos announcing an herbal medicine from Congo that promises health and wealth. Curiosity, laughter. Jack and then Scott took some snaps of the festive market. Enjoy.

Seen and Not Seen

There are two accounts of the actual Christmas Night in the Bible: Luke 2, and Revelations 12. Yesterday for our staff CME/Bible study, we looked at both stories, printed out in parallel on a page. First we read Luke 2, and I asked every few verses for people to describe what they would have seen if they had been there. For the most part, it would have looked a lot like every-day Bundibugyo life: a pregnant woman, crowds, walking; chaos of disruption caused by arbitrary governmental decrees; the onset of labor at an inconvenient time and the search for a protected spot; sharing a shelter with animals; giving birth in unhygienic conditions without medical care; a not-quite-married pair of inexperienced parents; a baby wrapped up in scraps of cloth; the potential for death always quietly stalking in the background. Such a sequence of events could unfold today, here, unnoticed, because it is common. In fact it probably will, today and most days.

Then we turned to Revelations: here the pregnant woman is clothed with the sun and wreathed by the stars. Here the labor is on a cosmic scale. Here the baby is directly threatened by the waiting, gaping, hungry, evil jaws of a fiery dragon. Here the birth culminates in a barely-in-time rescue, sweeping the infant up to the very throne of Heaven. And here the sequence of events triggers a celestial war, with angels and demons and victory and defeat. I don't think most of the staff had read this before, and they were fascinated, laughing nervously. Because in Africa we don't doubt the pervading precence of the spiritual world, and the danger of the devouring dragon.

Both accounts are true pictures of reality: one a picture of that which was seen by human eyes, and one a picture of the unseen events that were occurring in the spiritual realm.

So we were encouraged to remember that what we see here, happening, tangibly before our eyes, is only a partial truth. The long line of patients with their needs represents dozens of lives in the balance, with eternal consequences. The tiny jaundiced newborn who responds to IV antibiotics so painstakingly given represents a victory that might be mirrored in a heavenly battle. The choice to come to work when most of the world around us is consumed in selling their cocoa and buying new clothes for Christmas day represents the kind of courage mentioned in Rev 12:11, the kind that overcomes evil, forever.

A few people in Luke 2 got to glimpse both realities, to see the material events in real time while recognizing their reflected spiritual impact. Mary, the shepherds, Simeon, Anna. For some, because God by grace overwhelmed them with inescapable visions. For others, because they had dedicated themselves to the search, and recognized God's hand in events. I'm praying to become that sort of person, grounded in the hands-on messiness of life and death on the streets and stables of our earth, but able to see the pattern of God's work, and be carried along by faith and hope, the unshakable evidence of things not seen.

A week 'til Christmas . . .

And the stockings are hung with care, though we don't have a chimney.  The cookies are being consumed as fast as they can be produced; the Christmas music, from baroque to Bing, carries through the house.  Most of the day our extended "family" of friends/students hangs out here.  Some have been with me at the hospital daily, and with the ward quieting down a bit (we actually have a few EMPTY BEDS instead of overflow on the floor!) I have enjoyed doing actual teaching rounds.  In fact, I'm hoping the alliance between them builds for their future in Bundibugyo:  we have a pre-doctor, a pre-nurse, and a pre-clinical officer, two of the three were school-mates at CSB, and it is a privilege to be living here on the cusp of transformation as these kids get the education and vision to serve.  The rest have done some projects around the house, including a tree-seedling-bed for Julia's tree project (she has visions of Wangari Maathai).  By 1 we are all back together for lunch, catered all week by my neighbor in the effort to keep a dozen teenagers fed.  We eat together and talk.  A couple of videos (their choice, State of Play, my choice, A Christmas Carol) in the afternoons, and a few soccer games, lots of card-playing, book-reading.  I can sense that the separation created by sending our two oldest to an American boarding school is not fully bridged in their return, that there is a new caution on their friends' part here, and a new reluctance in my boys' hearts who have tasted a different sort of camaraderie now, part of the cost of being of many worlds.  By late afternoon the students all drift out to their homes or other places, and we get a daily handful of other visitors, or occasionally go out for a visit ourselves.  But the evenings and nights have been quiet, family-only (mostly) times.  This is unusual in our house, and we purposely set boundaries with the bittersweet realization that this is our last Christmas before Luke goes to college, perhaps our last Christmas as as we know it in this house where we've had so many . . . so at our kids' request we've had sumptuous family feasts on our Christmas-holly plates, good conversation, candlelight.  And tonight will be the 6th and final episode of Lord of the Rings, watching the extended version a disc at a time.  Like Mary, I'm treasuring all these things in my heart, grateful for these days, knowing I can't hold on to them forever.

A decree went out . . .

Not from Caesar Augustus this time, but from the personnel office and the Chief Administrative Officer, that every health worker should report to the central offices to be counted and documented.  I suppose the disruption does not compare to that of Palestine two millennia ago, but in my narrow world it felt rather significant that EVERY HEALTH WORKER was to simultaneously leave his or her post and gather in one spot.  In some places an administration might consider the ongoing necessity of health care and worry about taking every nurse, every midwife, every lab tech, every person off duty district-wide for two days this week.  In fact they might consider leaving their office and traveling a few miles to count and document  personnel AT the hospital rather than calling the workers away.  But not in Bundibugyo.  Just like in Jesus' day, the powers-that-be make their declarations, and the small people have to sacrifice to comply.  Of course when we started making phone calls we were told that it was all an abrupt plan from above, that the district was powerless to stop it, that no one had been informed, that of course the workers could stagger their reporting or send representatives.  But by then the masses were not going to risk losing their perpetual pay-check, and EVERYONE decided to heed the call.  Everyone except our most senior staff member, the in-charge clinical officer, who dutifully rallied and stayed on site.  Biguwe is a good man.

Which is why I am particularly grateful for the student rescue.  Our med student Baluku Morris, two of my CSB students Birungi and Mutegheki, and my own personal student-son Luke, stepped in to save the day.  Particularly Luke and Mutegheki, who ran the HIV-nutrition program today.  I suppose since we were gone last week and next week is Christmas week, a month's worth of patients decided this was the day to come!  All four young men worked very hard, weighing babies, counting out eggs and beans and pills, writing in ledgers and charts, translating and organizing.  I think they got to see some science-in-real-life as we talked through cases, as well as get a sense of the hard work and important consequences of medical service.

And in the midst of frustrations with the poor planning, with the usual sadnesses and struggles, two outstanding moments of redemption today.  First, a chunky cute little six-month-old whose AIDS-patient mother wanted to save his life by weaning him, but only if he was actually not infected.  His blood screening results were not yet back, but some phone calls to the lab in Fort Portal actually worked, and we found out he was HIV-negative.  Unusually, both mother and father were present together, and their joy on hearing the news fortified me for the rest of the day.  And, to save the best for last, Masereka Jokim smiled.  This is a 9 month old who has been barely alive at 4 kg for several weeks, one of the most skeletal and scabby infants I've ever seen, held by his all-alone Congolese mother, inactive and whimpering.  Over the last few days he finally began to respond, to be hungry, to drink, to inch upward in weight.  Today he hit 4.5 kg, and as I examined him, he looked up and SMILED.  This is a monumental sign-post of hope.  

We can live through arbitrary decrees, absent staff,  and just about anything for a smile from Jokim.

Congratulations Scotticus!

Good news on our email this morning: Scott Ickes defended his doctoral dissertation at UNC, using data gathered right here in Bundibugyo! This is an amazing feat, and one which only someone of Scotticus' can-do nature could pull off. The BBB arm of BundiNutrition was developed by another 2-ish year missionary, Stephanie Jilcott, who initially wrote up the funding as a post-doc for a Fulbright Scholarship but ended up putting together a program for our mission and working here to implement it. Scott was teaching our kids and coaching track and taking a pause in his own doctoral program in nutrition at the time. By the end of his commitment in Uganda, he had decided to return to UNC and complete his degree. I remember well the late-night discussions on our patio, waiting for bread to bake in our brick oven post-team-pizza, talking about his future and providing a listening ear. But when Scotticus did come up with a dissertation plan based on Bundibugyo . . . I was not a believer, I'll admit that right now. I was very worried that the inevitable frustrations and inexactitude and muck of life here would derail his educational success, and said so. Thankfully, he didn't listen to me . . . and others were more faith-filled. With the help of Baguma Charles, a couple of short term trips, efforts from half our team and especially Nathan, the project continued. A couple of posts ago I quoted Elizabeth Elliot who says that we missionaries should not be afraid to take a critical look at our work, our impact, our successes and failures. I like the fact that thanks to Stephanie and Scott we have done just that with BBB. We learned through his research that our educational messages to caretakers had to be tailored to address diluting methods of cooking the food we gave. And in spite of that, we learned that only about a third of what we distribute is actually fed to the malnourished child. We learned that the caretakers face significant hurdles to come even to the decentralized closer-to-home programs. We learned that the program significantly changes and IMPROVES the quality, variety, and amount of feeding, even after the families are no longer enrolled. We learned in spite of that, the diets of children in Bundibugyo are particularly lacking in protein and calcium. Which gives further impetus to the newest branch of the Matiti project of BundiNutrition, developing local breeds of dairy goats for ALL children to supplement their diets with milk.

A "mission" is so many things, the hands and voice of Jesus to the poor, the seeds of a church, a small factor of justice in a messed-up world, the inadvertent importation of values of a foreign culture. . . .and the incubator of the next generation of leaders, both Ugandan and otherwise. Baguma Charles is also applying to grad school. One of our Kule-Leadership-Fund med students appeared to pitch in at the hospital yesterday, on his Christmas leave, while a second stopped to greet us and a third called on the phone. Nathan is in the middle of a week of med school interviews back in the States, having decided during his work here to become a doctor he began the application process so that God-willing when he finishes in Uganda next summer he'll head back to school. Sarah has applications in for an MPH. A former engineering intern Josh is back in touch this month, nearing the end of his graduate studies and processing the possibility of return. And on an on. It is a privilege to cheer from the sidelines as God uses the unique experience of Bundibugyo to propel these young men and women along their journeys. And to cheer when they reach significant milestones, like Scotticus!