must-reads

For heart-felt reality and worship coming from adversity:  Scott' Day in Kampala, which inexplicably got relegated to two days ago several posts below.

For sheer excitement and a few hard lessons:  Scott Will being chased by buffalo, from the side bar go to blog and go down a post or two.

last ride?

Sticky evening air, dust rising from the road, shouts of children
running through the cocoa groves, fathers relaxing in the sling-back
reed Bwamba chairs holding a toddler on their knees or playing cards
or drinking, groups of women peeling matoke or sorting through cassava
leaves, girls sloshing water in jerry cans, more school-boys with
their mocking hellos, break-neck barreling motorcycles, friends
calling "Jack-a, Jack-a" or "muka-Scott (Scott's wife)". I answer
some particularly nasal semi-English greetings in Lubwisi, and the
little boys chasing behind my bike call to onlookers (in Lubwisi) "she
doesn't speak English, she only knows how to speak Lubwisi!" Guess
they missed the point. Hazy rose horizon, sweat, pumping up hills,
gritty teeth. Evening bike ride.

Perhaps my LAST evening bike ride with my youngest.
1. Graded road = speed = momentum = danger.
2. Male chromosomes = risk-taking = ride down the hill with hands in
the air = fear in my heart as Jack sprawls across the road. He gets
up, unhurt, rides on, the only casualty the phone I entrusted to his
pocket. Oh well.
3. 12 = last victim of puberty in our family = muscle and speed = me
left gasping behind the child I used to wait for.

It's a new era in parenting, the mom-left-behind era. I'm not quite
ready for the rocking chair . . but realistically I'm now the smallest
and weakest in the family, the slow-down factor. Good thing they
still like my cooking.

on bugs and concentration

The pace for the day began at 3 am when I was awakened by Star making strange, half-whine half-snuffle noises that I recognize as distress. And as I rolled out of bed with my flashlight (Scott went to Kampala or I would have definitely woken HIM up to check on our safety) and walked outside, I diagnosed the problem as sharp stings attacked my bare feet. Biting ants had invaded Star's dog house space, and though she had stretched the leash she's on at night to the max, she could not escape them. I released her and she shot into the house, where I helped her get some of them off and sprayed, and she ensconced herself in Caleb's room for the rest of the night.

That pretty much set the tone for the day. We may build with cement and connect to electricity, but this is still an equatorial jungle. The insects rule.

By morning the invasion had formed an orderly line running less than a meter from our door. I stepped over it and noticed that there was a lot of debris on the side-porch bougainvillea-covered patio. Debris interspersed with tiny grey bird feathers. Then I looked up and saw that the line of mpali was marching up the trunk of the bougainvillea, into the branches, and swarming itself around a nest of presumably ring-necked doves that like to live there. A seething mass of ants had devoured the birds. Which happened the one time we tried to have pet parrots. . . Nature in Africa is not for the faint of heart. Thankfully my neighbor Saulo who does yard-work for us is quite competent with ant-killer and a panga, so I left him to deal with the mess and went down to the hospital.

Patient 1: a very very ill, anemic, 8-year-old boy, who desperately needed a blood transfusion, but we were out of his type. Phone calls, some small money to help him get to Bundibugyo. As his mother hurriedly picked up their mattress and things and left, I began on the next bed, Patient 2: a very confusing and unusual case of massive ascites in another young boy. While I began to see him, Heidi noticed a few roaches left behind from Patient 1's departure, and very reasonably reached into the store room to pull out a can of Bop, the insecticide spray. None of us could have imagined the horror movie result. The three modest roaches died. But the spray disturbed the dozens, maybe a hundred or more, other roaches that were hiding behind beds, in cabinets, in dark spaces all around. Suddenly there were 3, then 5 then 10, then 30. Huge ones. Flying ones. Scurrying ones. I keep trying to examine my patient which is not easy when an occasional nuclear-powered roach tries to crawl up my leg. Nathan arrives and tries stomping them out. Nurses and patients are laughing and stomping here and there, not nearly as perturbed I'm sure as Heidi and I were. I'm listening for subtle heart sounds but rather distracted by the 3-inch roach crawling across my patient's sheet. Hitchcock should have had film running.

And it kept going with that whole area of the ward. I was reminded of a video game. We aren't too high tech but Jack plays one on my phone where he's trying to knock things out of the sky while simultaneously being shot at. The idea is to focus. Good prep for this kind of medicine I guess.

And at the end of the day, Nathan got his turn to test his focus. I was helping him learn to do a lumbar puncture on a very ill neonate (15 year old mom delivered at home then after a week came in because the baby cries so much). As he's about to put the needle in, the baby shoots a warm orange stream of stool explosively out his bottom. Quick-reflexes, Nathan jumps back. We re-clean and re-glove, and he's through the skin on try 2 when another patient bursts into the treatment room with a convulsing child, and absolutely no qualms about getting right in our way. Heidi thankfully moves them over to the side and administers valium just as thick yellow purulent CSF fluid begins to eke out of the needle. Not what you want coating your brain, and we are not surprised the baby cries a lot . . .

Bugs, seizures, streams of diarrhea, and other hazards not withstanding, we finally finished the day relatively intact. Until I got back home to be informed that though the mpali are now gone (many dead, thousands and millions more diverted) one small problem remains: a cobra came out of the cocoa behind our house and got away before they could kill it.

poisonous blessing

Can a snake bite be a blessing?  Saw it happen this week.  A little 5-year-old boy woke up crying beserkly in the night, and his neck began to swell.  Parents noted what looked like fang marks at the base of his skull.  Snakes can enter mud/thatch homes fairly easily at night, seeking warmth from a kid sleeping on a mattress on the floor, then he turns and the snake panics and bites.  Most envenomations here cause local swelling but are survivable. In this case we noted that his sister, sitting by him in the hospital, looked rather stick-limbed.  We asked mom to bring her records.  She turned out to have sickle cell anemia and be moderately malnourished, qualifying for Plumpynut.  Then since she was positive we tested our little snake victim, who it turns out also has sickle cell disease.  So five days later the family is leaving with a healed and perky 5-year old, but more importantly two kids enrolled in ongoing care, getting daily medicine, and getting nutritional supplements.

I suspect there is a deep underlying truth here.  Joseph told his jealous, plotting brothers that what they meant for evil, God turned to good.  I'm afraid we often live in the moments of post-snake-bite distress, and fail to see the sure, slow good being accomplished.  Severe mercies, poisonous blessings.

a day in Kampala

Scott here. While Jennifer is at home battling the roaches, snakes, and biting ants, I'm here in Kampala merely to run a few errands and pick up Luke and Caleb at Entebbe airport tomorrow as they return from RVA for their post-term break.

Ahh, to escape the relentless demands of Bundibugyo for Kampala, the big city with cappuccino, air conditioning, malls and a movie theater. Or not.

Kampala is a city of 3 million people and maybe 5 million cars, motorcycles, and buses? Seems that way, anyway. My battleground: the gnarly gridlocked streets. My objective: passport pages, dog vaccine, annual park passes, grocery shopping, and a truck tune-up. Not a glorious life-saving agenda, but mundane stuff nevertheless which needs to get done.

Jacob Zuma, the President of South Africa, graced our capital with his presence for the past two days. As usual, the elite live and move at the expense of everyman. Road closures all over the city facilitate easy movement of the big dogs while every intersection chokes to stagnation. Walkers outpace cars—easily. The only way to really make progress in this situation is to hop on a "boda-boda" motorcyle. These scooter taxis weave between the clogged cars, zoom wrong-way down on-coming traffic, and jump onto sidewalks in order to speed their passengers towards their destinations. Some say that their proliferation is a reflection of the failure of the public transport system. Jonah always warned me against riding them. "You're not likely to die while riding one… only get maimed for life." That statement came after his trauma rotation in Mulago Hospital where the orthopedic service runs something akin to the civil war era practice of hacksaw amputations. So, I advise my team against riding them. Do as I say, not as I do. Today, with 2 days of errands to do in one day and my truck in the garage, I rode several miles through the horn- honking, mud-splashing, dog-eat-dog, might-makes-right, pot-holed roads of the "City-of-Seven Hills" on several—and lived to tell the tale.

My first stop- the USA Embassy. Their progressive "on-line appointment system" nearly thwarted me, but I planned a week ahead and got the last appointment available during the two days I am in Kampala. I was thankful and snatched it up. Now with our frequent RVA-related trips to Kenya and the fact that all the East African states use full-page stickers for their visas, our passport pages are eaten up in a hurry. Jennifer's passport is down to only three free pages. With a trip to Kenya and then on to Greece in May for our Triennial WHM Retreat coming up --she needs more pages. I planned ahead enough to get the appointment, but did not anticipate that I would be sent away from the embassy because Jennifer was not present to sign the application herself to GET MORE BLANK PAGES. It's not like I was trying to change her name or something…all we wanted was more blank pages. So, now we must return a day early on our way out in May, spend an extra nights lodging expense so that she can get do what? Get more blank pages. Sigh.

Next—five miles across town to the university small animal clinic where I got vaccine for our dog. I could tell by the way that they looked at me that they were prepared to refuse to give me the vaccine until I pulled out my handy-dandy collapsible cooler with a pre-frozen ice pack inside. This time the preparation resulted in achieving the desired objective. Score.

Next…the park passes. We pay a flat annual fee for special passes which allow us unlimited access to every national park in Uganda. The tricky part—I only remembered this task at midday. The application requires passport photos from each applicant. Without any of the family along, I resorted to hacking family photos from my laptop. So, back across Kampala to the guest house to grab the computer, cut and paste some head shots into a one-page 8x10 for printing, go back across town to a photo finisher, wait for the photos to print and then across town to get to the Uganda Wildlife Authority before closing. Non-traditional passports accepted, application completed, US dollars in my wallet enough. Done. Made it back across town before the garage gate closed and got our truck, now ready for another 3000 bruising kilometers before the next tune-up.

This morning these mundane errands seemed to require a Herculean effort to overcome the life-sucking traffic jams and the finger- wagging bureaucrats in pursuit of my ordinary goals. Though my spirit felt like it was ready to boil over from anger at midday, this evening I have returned to the psalms and the sacred sorrows there. It is where we see adversity acknowledged and articulated…and eventually set aside as it is put in perspective. The "vav"—the signal of the switch in gears from lamentation to worship—signifies the heart acknowledgement that everything pales to nothingness compared to the living God. Just wish I could see that big picture a little easier when I'm in the thick of it all…

solitude and silence

In Bonhoeffer's book about Life Together, solitude and silence provide the context for the inward disciplines of meditation and prayer and intercession for others.  Certainly our team has prioritized the "day alone" in new ways in the last few years thanks to the encouragement of Donovan G, who is a minister-to-missionaries spiritual encourager.  We fast from busy-ness to create the space to focus on God, to listen to His written Word, to rest in His presence.  But I was very curious as to how this concept would translate cross-culturally in a place where few people have their own mattress, let alone room or house.  Where ancestors and descendants give life meaning and context, where clan and community reign supreme.  

Not surprisingly, few people here spend intentional time alone, ever.  Perhaps they might be left in bed on occasion during a sickness, but even then family and neighbors do their best to be omnipresent.  A few staff had experience of "quiet time" for prayer.  But mostly they expressed deep concern that to withdraw communicates pride, conflict, anger, superiority, separation.  In a culture where living spaces are communal and crowded, families huge, villages huddled, closed doors or shut shutters rare, where sharing is the highest moral value, and the group affords most of identity, where people prefer to do almost everything together, a person who goes off alone for hours is highly suspect.  Either he is eating/enjoying something he doesn't want to share, or he is passively aggressively punishing the group.

So what do African Christians do with Jesus' example of early morning mountain-top prayer time alone?  Of withdrawing to the desert to struggle with God?  

That's a question for them to answer.  I suspect that it is a bit like our team.  Until there is a critical mass of people who affirm the value of solitude and silence, few individuals will risk being known for it.  But eventually it will become a part of the rhythm of life in community, perhaps with different cultures having different patterns and proportions of time alone and time together, but all having some devotion to both.

Bundibugyo's first chocolate bar

Back in the day, our predecessor Alan Lee (according to missionary lore, I wasn't there) forbade his team from bringing chocolate bars into Bundibugyo. This was a relatively pristine, un-westernized, un-reached area, and he did not want our mission to unduly impact that. Twenty years later, John Clark and CSB agriculture teacher Alex created a chocolate bar from local ingredients.

In the interim, major cultural shifts have occurred. An improved road, trade, electricity . . and a complete switch in the cash crop from coffee (blighted by a disease in the late 90's) to cocoa. Everyone and anyone grows cocoa now, shiny-leaved short trees with their improbably wrinkled crimson pods. The population organizes itself around the cocoa harvest. It is the single greatest industry. Everywhere, beans are spread in the sun, drying. The middle-man buyers from Kampala come on the 15th and 30th of the month, and then there is money, for school fees and other priorities. Buyers sell to major companies for export and processing abroad. But the local farmer gets a relatively low price compared to the worth of the final product, the bar of chocolate created in Europe. A few years ago Luke tried to process and make some chocolate which was part of a now famous research paper entitled "From Bean to Bar" . . it was a tasty prototype, but the consistency was far from smooth.

Now John and Alex have begun to explore the possibilities for some further processing of local cocoa, specifically from the CSB farms. They harvested cocoa from the farms, fermented it, dried it. Roasted it. Ground it. Ground it again. Mixed in some sugar and milk and cooked again and cooled. And produced something with the texture and appearance of a real chocolate bar. For sure the first one created in Bundibugyo, maybe in Uganda (??). If we were wine critics we'd have words for it: earthy, fruity, tangy. John wants to improve the fermentation process to decrease the acidity. But it's a start.

Perhaps one day Bundibugyo will be known for its fine organic dark chocolate. In the meantime, we took some of John's product to the CSB staff at last night's Bible study, and they were enthusiastic. These are the sort of things that build a people's sense of honor, place, loyalty. I'm sure Jesus, who turned water to wine, would appreciate the gift of tasting the fruits of the local trees.

Happy Birthday to Karen

Karen Masso shines like a star in the universe (see Phil 2:15): a person whose life ONLY makes sense if the cosmos is infinitely larger and more spectacular and more glorious than the glimpses we get in the dark. Stars are quiet. They do not beat down their light and force you to take the cover of shade, or even notice them. Karen is like that, someone whose beautiful deeds are not paraded, who stands out in the darkness if one takes time to look. In her many years here in Bundibugyo (and her year-and-a-half in Mundri) she has provided gracious loyal unswerving friendship, countless practical helps, an ever-sympathetic ear and heart, skillful organization, courage and vision for feeding the motherless and infected, faithful fundraising, nurturing parenting of her own kids and ours . . . . and hundreds of somewhat smelly goats.

Bethany asked Karen's friends to organize tributes for her milestone birthday. We tried, but I realized today that God had organized a very fitting one. It was discharge mania at the hospital. NINE malnourished children departed, cured. That must be a record, not soon to be repeated. We certainly always have the hungry with us. And if two improve at a time, we count ourselves blessed. When nine go home at once, shooting up on their growth curves to arc over the cut-off line of survival, we have to take notice. This is the main arena where Karen poured out her soul in Bundibugyo, so it is very appropriate that we celebrate these cures as we celebrate her. Some examples: little preemie Isingoma, who took 70 days to move from 860 grams to 2 kg, being held by his warm mother's skin as his only incubator, spoon fed and protected. Asaba, smiling, whose grandmother almost gave up, home today after six weeks of struggle, plumped up. Bikorwa who was almost dead from TB ten days ago, turned the corner from anxious oxygen-deprived gasping to playful alert smiles, is well on the way to health. Faisi, motherless, with his dedicated grandma. A baby from deep in Congo, whose low-IQ mom just needed TLC herself for a couple of weeks to learn to care for him. And two sets of twins, one of whom has TB AND sickle cell anemia, and also took six weeks to achieve health.

All of these children salute Karen today, and together we wish her many more years of shining.

Riding the billows of the deep

We're on a wild ride.  2009 was a long and painful year on many levels, with losses and struggle.  2010 has so far been one of building momentum and out-of-control Kingdom-come.  This week I got the mental image of being in a river as it approaches a waterfall. The current builds and churns, and there is no fighting it.  

Scott and I made a list of seventeen really priority-type things we believe God is calling us to focus on and strive towards in the next few months, in addition to four meetings we prepare for each week (three are Bible studies or teaching of some sort).  These are outside of the normal daily work of seeing patients, making rounds, cooking, parenting, maintaining life, drawing in new team mates.  There is a lot going on here. Which has tends to make me feel panic, as if I'm going under the water, fast.  

But some words in Paul Miller's A Praying Life jumped off the page:  Instead of fighting anxiety, we can use it as a springboard to bending our hearts to God . . when you stop trying to control your life and instead allow your anxieties and problems to bring you to God in prayer, you shift from worry to watching.  You watch God weave his patterns in the story of your life.  Instead of trying to be out front, designing your life, you realize you are inside God's drama.

Riding the raging current is perfectly safe, if the river is God himself.   Jonah said "For you cast me into the deep, into the heart of the seas, and the floods surrounded me, all your billows and your waves passed over me."  And in Psalm 42, "Deep calls until deep at the noise of your waterfalls; all your waves and billows have gone over me."  

The ride turns from exhaustingly terrifying, to exhilarating, when we get a glimpse of God in the waves.  He has answered numerous specific prayer requests in the last ten days, from tremendous unlooked for gifts of support to a divinely orchestrated timing of the vaccine advocacy during a meeting on the very subject.  This encourages us to go with His flow, and wait to see more.

So don't pray for us to be airlifted OUT of the chaos and flood, but rather to pray IN the chaos for a deep connection with God.

Nyahuka News

The road grader has made its intermittent and unpredictable appearance, like some mythical beast, chugging and roaring down the dirt road, stirring up rocks and roots, mud and clay, making the way straight once again.  At least until the next rain.  Pot-holes and irregular mounds have been evened and crushed.  Market trucks have taken only moments to realize their good fortune and increase their speed from uncomfortably wild to dangerously reckless.  I can't imagine that we'll make it through the day without a trauma.

The district math contest, with no warning or preparation, is occurring right now.  I got a call at about 8 am from the math teacher, Desmond, saying they were all waiting for Jack and Julia.  Who knew nothing about it, slurped down a bowl of yoghurt and granola and zipped down to school to spend their Saturday morning taking an exam.  Luke went to the regional level a few years ago, so I guess Desmond had hopes for Jack, who is very similar, but a relative year younger.  Julia is the only girl in the advanced math class, very capable, but mostly discouraged by it.

Nathan and Assusi both received news within 24 hours of the death of their elderly grandmothers.  One of the true costs of discipleship here, being away from family at significant times.  We gathered around Assusi and helped her get on a bus to Moyo, on the northernmost border with Sudan, a two-day trip which hopefully put her there just at the end of the burial ceremony, while the clan was still gathered.  As the last relative in that generation, this funeral would be a unique time for many of the family to come together.  Nathan also struggled with whether to go or stay . . . he had said his goodbyes over Christmas knowing the end was near.  It takes more like three days to get from Bundibugyo to New Jersey, making it almost impossible to reach in time.  In the end, after much anguish and discussion with his family, he decided to stay here.  We toasted Lora Lee Elwood at dinner and read her obituary and listened to stories about her, which is a far cry from being at the service, but something.  As it turns out she was quite a lady, working for the foreign service and living in many countries around the world.  The family decided to direct memorial gifts to CSB, for which we are very grateful .  Both Assusi's and Nathan's decisions required significant sacrifice and loss, to go or to stay.  Heidi also lost her grandmother this past month, and in her case we all knew it was the right thing and important (and more possible since we were in Nairobi) for her to go back.  John's grandmother died last year, as did my grandmother-like aunt.  Neither of us went.  These decisions are difficult, and individual, and we are thankful for the freedom to make them differently.  

The water line is trickling . . because spiteful residents near the source routinely interfere with the system by opening the control boxes (padlocks gone, don't ask me why) and shutting down the flow.  We received notice that all three massive water reservoirs on our property which supply the entire metropolis of Nyahuka are slated to be destroyed by the road paving project over the next few years.  Not to mention all the pipeline.  A public health emergency looms.

Two cases this week of acute flaccid paralysis, which is potentially caused by polio.  This disease should be eradicated, but our proximity to the black hole of under-immunization in Congo means the risk always lurks.  Not to mention our gap in vaccine cold chain over the last few months, thankfully fixed.  Two six-month-old infants with limp legs wait to find out their diagnosis, samples having been sent to Entebbe.

The four protesting school football teams seem to have made their statement, and have returned to play today in the much-disturbed district tournament.  CSB gets a rest, as the innocent party.  A glimmer of justice.

Our primary school teacher neighbor came to request the mission megaphone . . for Nyahuka Olympics to be held on Monday, a track and field competition for primary schools.  Hooray for kids, for sports, for organized activity!

Mangos are appearing.

Our dear friend Karen Masso has a significant birthday milestone approaching.  We heard the president of South Sudan might be dropping by their town.  Karen is the kind of humble and gracious missionary for whom God just might arrange a birthday greeting from the president.  Also the Mundri team is NEARLY READY to move into into their new housing.  At last.  We wish them much joy and fellowship, respite and reflections of Heaven there.

That's the weekend news, from Nyahuka.