quotes of the day

"Heal-or-Heaven".   Prayed this morning that God would either heal Ivan Tumwiine, or take him to Heaven.  Not something I normally pray, but this child has suffered for about four weeks, his little skeleton draped with sagging wounded flesh, his swollen feet the most substantial part left of him.  He's got sickle cell anemia and probably TB too, and he came in starving.  Whenever he gets some milk into his gut, he loses more ground from diarrhea.  When he refused to even sip from a spoon for a while he had an ng tube, but eventually the energy loss of fighting it seemed to outweigh its value.  His mom had another baby while he was admitted, so now she has to divide her time, and he's frequently left moaning on his bed.  Some kids can be pulled back from that, but metabolically Ivan's body has so altered in his months of slow death that I'm not sure he can turn around, and if he does the impact on his brain might be severe. I'd love to be proven wrong, and Kabasa who got two candies today (instead of the traditional one candy) for reaching his target weight is a living reminder of those children who take a long time but do eventually heal, and smile, and chase balls.  After praying the Heaven-or-Healing prayer early morning, I cautiously looked at Ivan's bed when I walked in the door, but there he was, alive, barely.  

"They left us without an answer".  Sat in briefly as John led a group of community leaders today in a discussion of improved agriculture techniques, after the dozen or so had toured our demonstration garden.  John's point and purpose was openness, cooperation, sharing of ideas and information.  The group was all for that.  Information, in this culture, is power.  Give away your food, but don't give out knowledge!  So our agriculture group's effort today was counter-cultural in the best way.  Interestingly, one of the men mentioned that last week in the build-up to the WFP anti-hunger campaign, someone came and met with their village (he thought it was a woman but seemed unsure).  She asked the parents why they think their kids are stunted.  People gave many ideas . . . but she never told them the answer.  I'm sure this woman left with a good sense of community discussion and mobilization and inclusion, and the reality is that stunting is a complicated endpoint reflective of many problems.  However her audience was left with the assumption that SHE knew why their kids were stunted, but she wasn't telling them!

"Christian brotherhood is not an ideal which we must realize; it is rather a reality created by God in Christ in which we may participate".  Last night we initiated our CSB staff Bible Study for 2010.  We had surveyed the teachers to see if there was interest, and what time would be most convenient for them.  Even when people express verbally or on a survey that they want a Bible Study, one never knows who will show up at 8 pm after a long day of work.  However, almost ALL of them did!  I think there were 25 of us, which is an unwieldy size, but they wanted to meet together rather than in smaller groups.  We are attempting Bonhoffer's book called Life Together, which is a study of Christian community.  All of the basics of a Christian life are there, but in the context of living in community (which we do) and in the context of Bonhoffer's opposition to political evil and personal suffering (which is a pretty African context, too).  Chapter 1 emphasizes grace:  our community may not match our mental ideal, which frustrates us and tempts us to demand that others change . . better to realize that we live in a real place of God's placement and choosing and look for ways to be thankful.  I was convicted of my own complaining heart, and long for the real love Bonhoffer describes which brings freedom to others as we long for Christ's best in them rather than OUR ideas for them.  Praying this study bonds us, missionaries and school staff, in a common goal.

"You number my wanderings . . "  Psalm 56 was our theme for early prayer meeting this morning.  It perfectly mirrors our vacillation between that desperate sense of being swallowed up by too much work, un-solvable problems, evil and corrupt people . . and then the flip side that God is our refuge, that He is FOR us.  I particularly appreciate the fact that God knows all 17 beds the Johnsons have slept in in 2010 as they wandered this way, and knows where the rest of our paths will pass this year.  He does not promise to avoid tears, but He does save them up in His bottle.  Sorrow and sojourn come, but He notices, and only allows what has purpose.  Clinging to that.

"At least you can stay for life".  This is my favorite.  Yesterday afternoon Scott was working with our new calf (he and Jack and Julia put up a fence!).  An acquaintance came zipping in on his motorcycle, having just heard the rumor which circulates every few months that we're pulling out of Bundibugyo.  He was relieved to find that we were still home.  Then he said to Scott .  . "Doctor, I know this is a hard place to live, but at  LEAST you can stay for . . . . (we're expecting something like one more year . . .) .. .LIFE."  Hmmm.  I guess compared to "at most you can stay for eternity", life is a short "at least".  

International Women's Day

Celebrated here in Uganda by:

First, my non-woman house worker took the holiday quite seriously, and did not show up, allowing the only woman involved in our house (me) to scramble with cleaning up an ant invasion and dishes and getting ready for the day.

Second, down to the ward, because sickness does not generally take a holiday.  Only to find that neither of the assigned nurses showed up.  One was mad because the other one skipped duty yesterday and left her alone.  Punishing me, and the patients, to make her point I suppose.  I was not amused, having left my own kid (Jack) home with a fever and strep throat, reading on the couch, certainly not as sick as many other kids but still . . . .  I called the more guilty missing-the-second-day person and she showed up two hours late.  Thankfully Heidi and Nathan pitched in, because the place was PACKED, no room even on the floor really.  Five tiny babies now in the 1.5 kg range (one of them has doubled his birthweight to get there).  It seemed appropriate to spend half of Women's Day doing what most women do:  enabling the survival of their children, priority number one.

Third, back to our house for an afternoon nutrition meeting.  Heidi, Nathan, John, Travis, Scott, Lammech, Pauline, Baguma Charles, and me, the mood lightened by one of my favorite International Women, Pat Abbott, who sent a care package.  We broke out some marginally nutritious pretzels for the occasion.  Again, a good way to celebrate women.  The 298 (one of the 300 fell behind a laying box and was crushed, the other was eaten after it was clearly lame and twitchy as per Pauline, which sounds a little scary to me) chickens have been scientifically divided into two groups to test the volume and duration of their egg-laying capacity on two feeds, commercial and locally mixed, in the hopes that a local mix would be more affordable and practical to encourage local farmers.  John and our extension agents are really networking well, drawing in schools and lead farmers to view our demonstration projects, exchanging ideas. All were happy to hear that an expensive stud male goat who is supposed to be contributing genetically to the dairy-goat leanings of the Bundibugyo goat population got over his long bout of the blues and seemed to finally catch on to what was expected of him with the female goats.  Seriously, we do have some fun meetings.  Lammech is ready to start the next round of training for HIV-positive families or caretakers of motherless children who qualify to get goats, and the next batch of 25 will go forth in April.  The main challenge for our two outpatient sites in education and nutritional supplement provision is the flooded rivers and muddy roads, making them hard to reach.  Again, dedicated people are reaching many women at the point nearest and dearest to their hearts, child survival.

Fourthly, without a pause, four of the team women changed into pants and t-shirts and raced down to CSB to join other staff (teachers and wives of teachers and a few other assorted relatives) in a Staff Women vs. CSB Girls' Team International Women's Day Football Match.  I'm sure my face is still red as I type:  intense sun this afternoon, the full field looked pretty dauntingly huge, and I haven't sprinted like that in a LONG time.  Lots of laughter, wild kicks, good dribbles, team work and fun.  Miss Ashley dazzled the onlookers by dribbling through four or more opponents routinely, and scoring a great goal.  Important, in my opinion, for establishing respect as the women's coach (no one can quite believe a GIRL can play like that . . . ).  We ended tied 1 to 1, which was perfect.  Considering I'm not only old enough to be the mother but in this fast-reproducing place the GRANDmother of most of the girls, I'm just glad to have held on.

Now, back home, Jack improving on antibiotics, Oreo getting stronger each day, Scott struggling with CSB computer issues and accounts, wishing there was someplace to go OUT for dinner instead of me thinking of yet another night's plan after I clean up from the day . . . 

Happy Women's Day.

 

Oreo

. . .is the proposed name for the calf that our faithful old dairy cow, DMC, gave birth to last night.

DMC is a no-nonsense Ugandan cow. Like many women, she bore her fifth pregnancy without a word of complaint and barely a hint of what was happening internally. It was only when her milk changed to a thick proteinaceous colostrum a few weeks ago that we were really sure she was pregnant . . . which was a posthumous surprise from Sir Loin whom we thought had failed to leave his genetic contribution behind him prior to his untimely demise. Yesterday Scott noted the passing of the mucus plug that portends labor, and when we watched DMC she laid down a few times and seemed restless. We decided to separate her from her 14-month-old daughter Truffle by closing the gate between the two halves of the pasture, in case Truffle bothered her, but he separation upset both of them so much we re-opened the gate. Other than that, nary a moo of distress escaped DMC's lips. We saw her at 10 pm, and when Scott made one final check about an hour later before we went to bed . . three pairs of eyes reflected in his flashlight: two big pairs at chest level and one tiny pair on the ground. We got more light and saw the fragile little black-and white calf. It rained most of the night and I worried about the baby being too cold . . but this morning, there she was, on spindly legs, following her mother. She's smaller than the last two calves DMC has had, and hasn't caught on to nursing yet. In keeping with our chocolate theme (Dairy Milk Chocolate is the mom, the name of a Cadbury bar purchasable here in Uganda, and her calves born here in Bundi were Ghiardelli (a dark-brown male whom we returned to Atwoki in Fort Portal) and Truffle (a cream and brown female)) Scott is calling this one Oreo, since she's mostly black with some white in the middle.

Besides being a fun farm real-life experience . . the calf means milk for our team, which sustains the life and growth of our kids. So we're very thankful and blessed with this new baby.

servant-leader

The vision for CSB has centered on raising up servant-hearted leaders for Bundibugyo.  Spend a little time anywhere here, and you will see that this is a desperate need for Bundibugyo (and the rest of the world!), men and women of integrity with the skills and humble hearts to serve others, to bless as they have been blessed. Sort of a central reason for our continued existence on earth when you think about it.

So Scott chose this theme when he was invited to speak at chapel this week.  He talked about leadership qualities, and then the story of how Samuel chose David to anoint as King of Israel.  People look for wealth, power, height, money, success . . . but God looks at the heart.  Then he took them to Psalm 51:  how do we get a heart that is ready to lead?  We ask God to create a new, pure, holy heart within us.  And He will, because He delights to do so.  By grace these kids can become the leaders of their families, their clans, their district and their nation.

Inspiring stuff, when you're sitting in a packed-out standing-room-only chapel, more students and staff present than ever.  Deus is leading this way, and people are following.  We are thankful for God's ongoing work at CSB, building on the efforts of the missionaries who have led up to now.  It is a huge job for Scott, though, to enable the staff to carry on this vision, to provide the financial accountability and motivation that keeps the school going, now without any other missionary standing with us there for the first time.  He needs prayer to keep the budget balanced (or at least not any more imbalanced than it was left) in the face of staff demands for this and that.  He needs patience to love people well, to support Deus, to deal with the lack of water and the constant crises.  

And we need more servant-leaders, missionary and Ugandan, to love this generation of teenagers who are emerging as the leaders of this new millennium.  I look into the sea of faces and see great kids, who have made mistakes, who need security and challenge and good examples.  And I look outside the gates and see dozens of other schools, thousands of other students, equally hungry.  Who need sports programs and clubs, who need accurate teaching and loving discipline, who need goals and dreams and the gift of positive adults in their lives.  Pray.  Ask God to send us the same kind of out-of-the box points-to-His-power help at CSB that He's begun to reveal in the medical sector.

On banging one's head repeatedly against the wall, and noting a slight budge

The last ten days have not been easy.  I have found myself in tears more than once.  And exhausted.  And stretched.  And wondering.  But looking back, I told our team during prayer time yesterday, that I think this month is a spiritually significant and intense one, and this is just what it feels like to be in the middle of what God is doing.

Because suddenly, yesterday, it started to dawn on me that a lot is coming together. The HIV-testing kits that we've made so many calls about:  a thousand delivered.  The medicines which have been out of stock for months:  delivered.  The entire murky non-functional supply chain that plagues us, we talked to UNICEF about supporting months ago . . . suddenly a competent qualified doctor showed up out of the blue, explained all the forms to Assusi and a few others, explained the schedule and procedure, and we have hope.  The F75 (medicinal milk powder for malnutrition) that we had not received . . located in a district store and handed over to my truck yesterday.  The gas cylinder for the fridge for vaccines:  here.  The immunization program:  resumed.  The blood for transfusions:  arrived.  The ward:  full.  The five-year-old who has struggled to survive his entire life and seemed for a full month to be on the brink of death:  turned a sudden corner, gaining weight like gangbusters, smiling, throwing a ball.  I wrote a few days ago about push, and how tiring it is.  And it is.  But then sometimes we see that God is really the one doing the pushing, and things suddenly start to happen.

This came to me in the Chief Administrator's Office.  At a low point this week, when I was being asked for money to buy SOAP so the midwives could wash their hands, and just tired of the constant little and big things that don't work and don't happen, I made phone calls about the lack of Primary Health Care funds that had been released this year.  I was frustrated.   We're in the third quarter of the fiscal year, and have received one quarter's money (about fifteen hundred dollars total to run a hospital from July to March, absurd).  So I went to the top.  The CAO is the highest position in local government in some ways. He is not elected, but appointed by the central government.  He controls the money.  So that's pretty key.  Someone else that was tired of being bugged by me gave me his phone number.  "Come to my office" he said.  So I did, drove to town after seeing patients, a bit tired by the ward and several procedures and new malnutrition cases and not too hopeful.  When I greeted him I realized we didn't know each other.  That's because our old CAO had been transferred, and this guy had been sent here 15 days ago.  

Well, it was one of those bizarre half hours that pop up in our lives.  The CAO told me straight up about changes he was making that were making him, shall we say, less than popular with some sectors as he refuses to pay out ridiculous requests, so he didn't know how long he'd last here.  He told someone to call in the DHO, the senior government health official, from a meeting down the hall, which did not make me too popular either, as it looked like I was trying to get him in trouble.  But we all talked together about the budget, about the procedures, about health, amicably.  People who stand against corruption fear for their safety.  At the end, I told the CAO that God had not forgotten Bundibugyo, that his appointment here was not a mistake, and that if God wanted him here no one could harm him.  Then I asked if I could pray for him, right there.  There were just the three of us in the office, and the DHO immediately said "Pray for me too!"  These are senior politicians, men who are older and more responsible and experienced and WAY more powerful than I am.  But I prayed for them both, asking God to give them strength to do the right thing, and to serve the people.

Between the entire World Food Program anti-Hunger campaign, the shake-up in district administration, the signs of break-through in supplies . . . not to mention the arrival of a fantastically servant-hearted and competent new family, the Johnsons, I am coming out of this ten days of struggle convinced that we are watching God move in.

So in our staff meeting this morning, I talked about prayer from Psalm 46.  Hundreds of people died in Uganda this week in a mudslide in the East.  Hundreds more died in Chile's 8.8 earthquake.  Rebel rumors swirl in Congo, as they do from time to time.  All of this, raging waters and shaking earth and war, is mentioned in Psalm 46.  But in the Psalm we see that God is in the midst of the trouble.  And God's presence transforms the trouble to blessing.  The chaotic waters become rivers of joy and healing for the nations.  So our little Nyahuka Health Center staff prayed big prayers for God's presence in their life troubles (one man's house had fallen in because of the rain, a few have not been able to get on the payroll due to horrible bureaucracy and corruption in spite of years of work, others mentioned anger over conflicts, desperate need for school fees, worries about their kids, sicknesses in their families, anxiety about safety, discouragement when they don't have medical supplies they need to do their work).  We turned to God as our refuge and strength and asked Him to come into the midst of all this mess, as He has been doing so clearly over these past ten days, and to do something big and transforming and good.

The wall is budging.  Slightly.  Keep praying.

Gender Confusion

Yesterday I was in Bundibugyo Town, where I am not quite so common a sight as in Nyahuka.  I was waiting for Assusi and as I stood by my truck, then climbed in, I greeted a little group of primary school kids who were walking by.  There were a few 9 to 11 -ish looking kids, and one smaller girl.  The older ones told the younger ones that I was somehow related to "Kevini" (Kevin B).  As they walked away talking loudly about me (always a peculiar sensation, to hear peoples' conversations who assume I am so other-worldly I don't understand, to be talked about as if not present) I heard the younger one ask the older ones repeatedly:  Is that a MAN?  

Now, I was wearing a below-the knees flowered skirt, had my hair down, curly, below my shoulders, was wearing large dangling silver ear rings.  NO MEN here wear skirts, have long hair, or wear ear rings.  I was feeling pretty ugly actually, as this kid could not get her head around the fact that someone who looked like me could be female.  Then I realized the problem. I had sat in the car behind the steering wheel, and was preparing to DRIVE.  The activity of driving seemed to trump the clues of skirts and ear rings.  The bajungu are bizarre . . but surely if one drives, it must be male.  Her friends corrected her, explaining loudly that I was, in fact, female.

So, just another missionary contribution to the world, rocking primary-school-girls' gender identity, by the mind-blowing reality of a WOMAN DRIVER.

Rwenzori Mission School, Class of 2022 and 2024 . . .

As Luke nears high school graduation, he will be the first of our missionary kids (?since maybe a Herron??) to have spent nearly his entire school life here in Africa. He started "preschool" at age 4 just to be part of the fun, but his dear teacher politely suggested after his first few days of class that his energy level might make it easier to wait another year . . . Then except for 2nd grade in Baltimore, his whole school life has been a mix of RMS (our missionary kid classroom) and Ugandan classrooms in Bundibugyo, and the last two years at RVA in Kenya. (Which explains some of his unusual advances and gaps, not to mention his unconventional tendencies I suppose.)

Now the cycle begins anew, as Lilli started Kindergarten, and Patton and Bryan preschool, on Wednesday. They were thrilled as only 3 to 5 year olds can be with their awesome teachers and new adventure. Ashley, Anna, Nathan, and even Jack and Julia, have poured incredible effort into the "new" RMS since we shifted up from Christ School property at the request of the Pierces to free up space there, to the former Tabb house. The new set up is probably three times more spacious, with great outdoor breathing room too. With fresh paint and artful arranging, bookshelves and rugs and curtains, it is a wonderful learning environment.

Pray that these new little RMS-students learn to love to learn as our kids have, that the teachers would lead them intellectually and spiritually as they have our kids. That RMS would be a stimulating and safe haven in a sometimes hostile world. That the quiet set-apart location would not be an invitation for thieves (two break-ins already have left us without things like pencils, scissors, and the tape/ear-set learning station). That this new generation of third-culture kids, the future leaders of who-knows-what, would be nurtured and prepared. That God would send us another teaching partner to come alongside Anna when Ashley finishes her extended term this summer.

Fun for us to have been here long enough to watch a full cycle from preschool to high-school and back to preschool again.

World Cup 2010, East Africa

Yesterday, Jack celebrated his real birthday with our smallish family, phone calls, a special lasagna dinner, flour-less chocolate cakes, and home made coffee ice cream. He is, after all, a child whose career ambitions vary between football, preaching, medicine and being a chef. He appreciates a good meal. But the real party was this evening. Thanks to a lenient vote from CSB administration his best friend Ivan was released from boarding school confinement to join us for the post-team-meeting World-Cup-theme party. We divided everyone up into 3-person football squads and while some made pizza others played through a bracket. Argentina (Jack, Ivan, and Julia) met England (Scott, Travis, and Ashley subbing for Lilli) in the finals and emerged triumphant. Ashley had baked a soccer-ball shaped cake, and we ended the evening playing a late card game with the over-five under-26-or-so crowd. On evenings like this I appreciate our team, the effort everyone makes to come together, to celebrate, to enjoy, a taste of the Kingdom.

Jack Thomas Myhre, 12

Jack is a child who lived through more between conception and birth than most people do in a lifetime: rebels, war, gunfire, fleeing, helicopters, potentially devastating illness, thinking we lost our home, crossing the ocean twice, moving countries. When I look at him now with his 99%ile height and his 99%ile brain, huge and healthy and brilliant, I have to be astounded at God's grace. He's a living testament to God's humor, bringing the least expected out of circumstances. Jack at 12 is handsome, mischievous, a rough-houser and a teaser who loves a good cuddly hug, especially with his dog. He's a reader and a footballer, fiercely competitive with no regard for his bodily safety, but also able to entertain 3 year-olds, build legos, roll on the floor. His physical size and academic atmosphere don't match his real child-soul-age . . which means that he absorbs a lot of stress and anxiety going through his days in an arbitrary and harsh system amongst older classmates. He ponders abstract concepts and metaphysical realities, usually quietly, until a question about God or eternity pops out. His messy handwriting is worth deciphering for great vocabulary or creative problem-solving. Jack jumps ruthlessly on weak logic or unfair pronouncements from his mom, or sister, but he also gently understands us and our ups and downs, and appreciates us. He adores his dad, requested to play a little football with him for his Bday, and has the exact same hair cut. He has even less patience than I do, and unfortunately that's saying something. He misses his brothers, bearing the highest cost of any of the six of us for the family separation, lighting up tonight when each independently called him with a group of friends from their dorms to sing Happy Birthday to him. He makes a point of being thankful. His doodles are amazing. And he's loyal to his friends and his sense of home and place here in Bundibugyo.

Tonight we celebrate this boy whose life we watch and hold with awe and caution, waiting to see what 12 more years will bring.

Push vs. Passivity

Much of life as a missionary and a physician in a rural, poor, marginal, and probably corrupt place involves PUSH.  By this I mean the extra effort required to make the system work the way it should.  One could simply go the hospital, do what one can do, and throw up one's hands about the rest.  Which is, after MANY YEARS of stress and defeat, the passive way that many of our colleagues cope.  And me too, some days.  

But not today.  As soon as I walked on the ward I found out that my newest admission had died at 2 am.  This was an extremely ill child with sickle cell disease and severe acute malnutrition, who had come on death's doorstep.  Worrisome, but we've seen many similar kids revive.  Only this time, the person who promised to bring the blood needed for transfusion never showed up, and no one noticed or did anything about it.  I called him today, and he said the district had refused to pay for his transport, because all their funds were frozen due to failure of our entire district to pay taxes for who-knows-how-many years (and who-knows where that money went).  This is not a new problem, and this lack of essential funds does not seem to have kept half the district health office from traveling to a seminar in another part of Uganda today.  Meanwhile the blood transport question was tied up with the propane gas cylinders that we have advocated for for the last month, which run the cold chain which stores vaccines which run the entire country's immunization system, which have been out of supply.  Finally they were delivered to Bundibugyo town over the weekend (after their own set of phone calls last week).  Just 12 more km to make it to the health center, but this required desperate pleading and phone calls to a half dozen people to accomplish.  In fact I just counted 7 calls and 9 sms's from this morning, the cost of getting those in power to agree to release a vehicle and fuel to bring the gas cylinders, plus personal contact with the lab and a person with a motorcycle and provision of fuel from my own pocket allowed the blood-cool-box to go and get blood and bring it back for the next four patients with dangerously life-threatening anemia.  Though all this should happen automatically, it DOES NOT.  The people affected do not cry out, they accept their inevitable problems.  And those who have some ability to make a difference are either overwhelmed by too many other issues, or profiting from the diversion of funds, or caught up in the same passivity.  

Mid-morning I realized that a neighbor's baby I'd seen early at my house never showed up for a lab test as directed.  Again, phone messages to the child's grandparents whom I know, pushing.  An hour later, they are there, and the child turns out to have severe malaria, AND sickle cell disease, AND need a blood transfusion.  The ward is not so busy, but still I spend half the morning finding the person with the key to get a patient the food they need for discharge, or leading someone by the hand to get their TB meds refilled after they defaulted, or encouraging an aunt to offer her newly-orphaned nephew her own abundant breast milk as the tiny infant screams in hunger, refuses spoons of boxed milk, but eagerly sucks her breast and falls into an exhausted sleep.  

Then "little-miss-polka-dots" shows up with her mother, my true hero of persistence, the antithesis of passivity.  The mom is convinced that we needed to file yet one more form with the police, or check on the "file" one more time.  More phone calls, the police confirm that the rapist whom we caught has been moved to a more secure jail in Fort Portal.  We discuss Miss Polka-dots' mental/emotional recovery, give candy and paper and crayons, unheard-of luxuries, and make sure she's in school.  Mom leaves, relieved.

The child I THOUGHT would die lives on, Ivan Tumwine, miraculously SITTING UP after a litre of IV fluid revives him, non-passive effort by Assusi.  Little five-year-old Kabasa has turned a corner, he smiles and runs after a ball, new appetite kicking in on his second week of TB therapy, and the possibility of healing dares us to hope.  Twins, and a one-year old girl whose mother had abandoned her but was convinced to return when she ended up malnourished, all go home today, cured.  Nathan discharges from the motherless program the very first new orphan he personally enrolled a year ago, healthy and alive.  New premature twins arrive, bringing our 2-to-3 pound speck-of-a-baby population up to 4 on the ward, too many for the side isolation room, so we cordon off an entire section of the ward after cleaning it well, and try to make it a safe preemie environment.

Very little of my effort today involved specific medical knowledge.  Very much of it involved a few resources that most people do not have:  about 4 dollars of air time, about 4 dollars of petrol, and the sense of outrage that growing up in a country that generally "works" lends to my perspective.  People who work in settings like this need prayer support, to not give up, to believe that a little more push is worth it.  I know I do.