Beans, bugs, hail, pink scrubs, and long needles, hope

Beans:  Ah, you know you're back in Africa when you buy a cup of dried beans at the market, bring them home, pour them out, and find out that about a quarter of the cup consists of sticks, dirt, and live bugs.  Sigh.  This requires spreading the beans out on a tray, picking out the worst debris, scooping them up as the bugs run away, then rinsing (i.e. drowning the little insects) repeatedly.  Then soaking overnight, then boiling for a few hours.  All for a bowl of chili tonight.   

Weather:  Yesterday, I ran out mid-afternoon as it started to lightly rain, because my neighbor's clothes were on the line.  But she saw me and said, leave them, the sun was going to return.  Today we had a staff meeting at 7:30 a.m., and it's pretty impossible to get the clothes washed and hung before 7:30  .. so it was about noon by the time I got back and threw them outside before our Swahili lesson.  Once again, it started to rain, and I ran outside, then remembered the lesson from yesterday.  I confidently left them hanging.  And hanging.  Through a total-afternoon down-pour, drenching.  Whoops.  Up the hill at RVA there was HAIL.  LOTS.  Yesterday a roofing sheet blew off the 3-story apartment complex under construction next door and landed in our yard.  Crazy.

Dress:  For a reason I have yet to understand, all the parents of pediatric patients are issued pink hospital scrubs which they wear instead of their own clothing on the ward.  So every bed has a pink-garbed mother (or occasionally a twin father) sitting in it, holding a child.  Hygiene?  A perk?  

Medicine:  Simply put, almost every patient we have on the Paediatric service at Kijabe would already be dead in Bundibugyo.  An 11-month old with TB pericarditis just transferred down from the ICU, and the doctor I'm following decides the effusion should be tapped.  There is a Chinese missionary radiologist handy who agrees to meet us in the ultrasound room.  He confirms the presence of the abnormal fluid around the beating heart, and then goes to search for a needle longer than the estimated 3 cm depth from skin to sac.  A little lidocaine (the radiologist), a little firm holding down (me, the mom is understandably shaken and unable, though she gives verbal consent as wanting whatever it takes for her child to be better), two tries, and then there is an abundance of light golden translucent fluid flowing out. Next bed is an 11 year old with pulmonary hypertension, echo-proven tricuspid valve endocarditis, hypoxia and fevers.  A few asthmatics, a diabetic, a sickler, a malnourished former preemie with rickets (really, classic xray and consistent labs, who would have thought on the equator, but it seems to be common because of the calcium-binding sorghum and millet in the typical porridge here), a baby with AIDS.  Two consults on infants with neurosurgical problems, open spinal cords and encephaloceles.  And not one case of run-of-the-mill malaria.  It's a different world.

Hope:  I went to my third meeting of the day in the late afternoon, and decided to try a few Swahili phrases from the day's lesson.  Which made everyone happy.  Even me.  It's a start.  

settling, continued

What takes up one's days as a doctor who is not really seeing patients?  I was pondering that last night as I tried to get out the door at 8 p.m. for a Bible study one of the volunteer pathologist couples invited us to in their home, and it kept getting later and later.  So, week 2 begins.  Early mornings, trying to be back in our routines of Africa, the pre-light quiet for Bible reading and prayer, the edge of dawn for a short jog (gasping, altitude, dim light and uneven roads, reluctant to venture far) and shower, kids getting up for school, breakfast laid out.  Only it gets light so much earlier here.  (We're a 23 hour drive east in the same time zone).  By 7 am we try to intersect at the table for a Bible reading and prayer then the kids head up the hill with their loaded backpacks.  Yesterday we had "senior staff prayer meeting" at 8, tomorrow "all-staff chapel".  Today we each put in a couple hours of Swahili study with our books and tape, interrupted by calls to the maintenance person to check and see if our house repair/painting could start today.  He asked us to meet him at the house which we did, and that seemed so promising, but when we checked back in the late afternoon nothing had happened.  Mid-morning we both tried to tag along on hospital rounds, to begin to get the feel for the mechanics and culture of medical care here.  There are not that many more pediatric beds in this hospital than Nyahuka, double?, but about a hundred times more staff.  Patients we saw this morning had notes in their records already done by the Kenyan medical interns, had lab results, were being sent for CT scans and echocardiograms in Nairobi, were receiving hospital-cooked food five times a day.  Patients were on oxygen, which came out of tubing from the WALL.  Nebulizers even.  Electricity.  Charts. Vital signs. No one on the floor.  

Noon, back to our duplex apartment, for another hour of intensive Swahili with a language helper.  Being used to this in our old days in Bundi, I started to tell him what we wanted to learn . . but this man is experienced.  He said, that's fine, but let's get the basics first, and then proceeded to launch into his lesson.  Lubwisi is a double-edged sword--so many of the words are close, but not the same.  Lina lianje nissioni Jennifer (my name is . .) becomes Jina langu ni Jennifer.  And all twenty times I said it, Lina threatened to beat out Jina on my tongue.  

1 pm, back to the hospital for the weekly pediatric case conference, the intern and clinical officer presenting.  This is a teaching time for the 9 Kenyan recent medical school grads serving an internship here, the handful of clinical officers in training, family practice residents, surgery fellows.  As the medical director reminded us, this hospital is 96 years old.  It is like stepping forward in time from Bundibugyo, a complicated steady institution directed by Kenyans for Kenyans, with missionaries in a supporting role.  A massive institution caring for the most complicated patients in the area, but also a teaching hospital, with conferences and lectures and research.

Late afternoons, errands.  Making rounds of the few families we know for advice or borrowing.  Running paperwork up to Bob C who switched missions and countries but is still his cheerful can-do competent self and has graciously included us in some of his administrative errands for RVA.  Walking to the dukas for flour and toilet paper and pumpkins and strawberries, carrying back an assortment of fresh foods to cook.  Taking down clothes from the line which blow dry in the breeze within hours.  Sweeping, baking, cooking, washing dishes, the basics of survival.  Homework help, emotional support.  Emails, holding my computer up at various voodoo angles on the front porch trying to catch a signal, or calls and sms's with the rest of our life outside Kijabe.  Discussing our WHM Africa fields together, thinking and dreaming, upholding.  Knocks at the door as various ladies try to sell their tortillas and muffins, flowers and crafts.  Ten days on the ground and only one direct begging ask from a stranger at the door. 

Sometimes another crack at the Swahili tapes in the evening after dinner and cleaning up.  Hearing about everyone's days.  We edge our dinner time back to 6:30 even though the entire missionary world around us sits down at 5:30 sharp, so we can enjoy candlelight at sunset.  But every few days we have to juggle the times because one kid or another has to be somewhere for something.  Reading about a patient's problem we just saw.  Following up on finances.  Advising Luke on his schedule woes.  The wind picks up as darkness deepens, and we're glad to be inside our little apartment.

Not a lot to show for these days, but the exhaustion tells me we're working hard.  I think it is the attention, the edginess of newness, the strain of listening to a new language and constantly meeting new people, the remembering of all the ways this is NOT home yet, the intimidation of stepping up a hundred notches in the quality of medical care we must offer, he dread of the even more unsettled days to come when we build up a habitable home from scratch.  

So the settling continues, and I'm wishing we could justify at least a whole month this way, but every time we're in the hospital we're told how great it is that we're finally here . . . nice to feel welcome, but a lot to live up to.  

The Healing of the Land

If My people who are called by My name will humble themselves and pray and seek My face, and turn from their wicked ways, then I will hear from heaven, and will forgive their sin and heal their land.  Now My eyes will be open and My ears attentive to prayer made in this place . . . 2 Chron 7:14, 15

My Bible reading today included this chapter, always an amazing one to revisit.  Solomon dedicates the temple in chapters 5 and 6 with a dramatic sacrificing ceremony, a full week of butchering animals and feasting and prayer and fellowship.  It's an amazing scene on many levels.  The concreteness of the attention to the furnishing, the value of the beauty, the gold and color, the sheer scale of the spectacle, reminds us that we are embodied creatures who thrive on the tangible, that art and food can be worshipfully enjoyed, that even furnishing a home can be a holy act.  Then God comes in a dark temple-filling suffocating cloud, so thick and awesome that the priests can not minister.  God's presence stops the very activity that we would all assume to be the most appropriate and commendable, which says something about His Otherness.  But I digress.  After the whole week of festivity is over, God comes to Solomon at night and echoes back Solomon's prayers as a promise.  He commits Himself to act.  To hear, to forgive, and to heal in response to the prayers of the people.

If there is anyplace in this 21rst century where this story is currently being enacted in real time, it must be South Sudan.  A faithful remnant of true believing Sudanese have prayed, and prayed.  And today the vote that was promised six years ago begins, in spite of many odds against such a process.  Decades of war and loss are beginning to be healed.  The referendum process will continue all week, then it will take some time for the vote to be tallied and results to be announced.  Please pray for the country of Sudan, north and south, this month.  In the northern area, the president stands accused of genocide and has vowed to turn that section of the country into a homogenized state under the rule of sharia law with Arabic as the only language.  The line between North and South is disputed, with 80% of the oil reserves in the South the North wants to hold onto the controversial remaining 20% in border zones.  The fate of Southerners living in the North, and of the districts along the border, remains unclear.  The ability of the South to manage a country bigger than Uganda, Kenya, and Tanzania put together with less than 60 miles of paved roads (total), where a 15 year old girls is more likely to die in childbirth than graduate from high school, remains tenuous.  

Healing needed for this land.  Let us join the faithful who are praying.

Week 1

Week one is a mixed bag, as most week one's are anywhere I suppose.  Because we've visited Kijabe so many times, even stayed here for periods of weeks to months over the years, because we've lived in Africa longer than anywhere else, because we know this is not as difficult a place to manage as Bundibugyo, because we've moved here for a whole spectrum of good reasons . . . there is a sense of expectation I carry that this must be a relatively minor adjustment.  And in some ways it is minor.  There is a cushion, and insulation from Africa, that exists in this American community.  Well, to a certain extent anyway.

But every transition costs energy and emotion.  We all pay a price.  Scott is spending hours searching on line for a used vehicle, going into town to look at notice boards and check out used cars, making phone calls.  And hours trying to set us up on a decent internet connection.  If you thought the presence of 100 families and even full-time IT employees meant this would not be much of an issue (as I did), we would both be wrong. The famed fiber-optic cable that reached East Africa runs a few kilmoters up the road, but there is no connection here.  The hospital has a server that is erratic and slow, and we spent about two hours with their IT person this morning trouble-shooting their wireless network, which seems to be non-functional.  The school seems to have a better system but does not allow "lower station" families to use it.  People buy little USB port modems that work fairly well but eat through the money in a non-sustainable way, charging per bit of information accessed.  So, having been spoiled by a few months in America, we are now slamming up against the reality of poor and expensive internet connection, and realizing how much we lean on it.  Caleb's cost is probably the jarring conjunction of the two heretofore separate worlds of school and family, being free from dorm rules but tied to family obligations.  Julia's cost came in the I'm-in-over-my-head first day of band, and we're taking a step back and working out some music lessons.  All in all she's doing well, especially after the soccer coach called last night after the first few practices and told her she's on the JV team.  Yeah!!  Jack's cost is just the tension of remembering assignments and books and duties for 7 classes all in different rooms and times.  He already got one warning for leaving his Bible in his locker during Bible class, and his geography class assigned an 11 page report on Kenya to include history, religion, tribal groups, towns, animals, birds, political structure .. with references . . that has him feeling pretty intimidated.  So he's anxious about doing everything right.

My cost?  Hmmm.  Probably battling the expectation that I should know what I'm doing, in the home-making (literally) and medical departments, sooner rather than later.  I've been waiting to invest in a home, and I'm waiting some more, and wondering if I'm hoping for too much.  I feel a little tenuous and lost, and hesitant to commit.  They typical newcomer sense that I should probably be doing something that everyone else is doing only I don't know what that is.  And more tired than I should, though sleep is slowly regulating, the altitude and the emotional edge in the family in general drains me.  

So that's the report on week 1.  Scott and I did spend a day in Nairobi and managed to buy many gallons of paint to spur on the process of readying the "new" house.  We even noted that we UNDERSTOOD a few phrases of phone conversation overheard while waiting for a clerk in one of the stores--Swahili has begun!  I go through the lessons constantly translating into Lubwisi and English at the same time, trying not to let the Lubwisi be completely smothered by Swahili.  And the highlight of the week, dinner with the Chedesters, a full-circle from our days in Uganda, being welcomed in a big way (a special chicken dish which would be the A#1 guest food in Uganda, and 2 strawberry pies which would be remarkable anywhere) by people who actually know us.  Nice.

Keep praying for the right vehicle to pop up, for our Swahili diligence and progress, for the house to be ready and settled soon.  And more importantly for the Sudan Referendum to begin constructively and peacefully on Sunday, for our Sudan team in diaspora now to hold on in hope, for our Bundi team about to receive a visit from a supporting church in the US, for CSB hiring new teachers and getting ready to start the year, for the blood bank to supply and save lives at Nyahuka Health Center, or Luke working on grant proposals for a study in Kenya next summer.  All the places our hearts try to keep, even while we are here!

First Day of School 2011

Today Caleb returned to his normal 11th grade classes after a month break (casual, no big deal, glad to be back, reconnecting with friends, more of a homecoming for him). And Jack and Julia spent their first day in 8th and 9th grade, actually their first day of a generally American school ever, except for a part-time preschool for Julia when she was 4. They came home chatty, encouraged about a lot of things (like the fact that they knew all the answers on the Geometry quiz, or the wild story their Biology teacher told of being accosted by bandits in a game park). The biggest stress was band for Julia, where she felt hopelessly behind as a beginner clarinet player, so we have to review that. Otherwise they are predictably tired, the strain of new place, new names, new people, new directions, new rules, new expectations, new food, new everything takes its toll. They miss Uganda, especially RMS. Keep them in your hearts as they move through their days, juggling text books and finding a locker and figuring out where to change for PE and what kind of paper the teacher wants homework assignments written on and all those things that will be second nature in a few weeks. Julia starts soccer practice tomorrow, too, she missed try-outs at the end of first term but we hope she'll be included in one of the teams.

Meanwhile our day consisted of Swahili study, laundry (a washing machine! and a dry high-altitude climate means the clothes dry on the line by noon!), cleaning, baking, Scott catching up on several issues as a FD, emails, searching on line for used cars, phone calls . . . and in the late afternoon, finally, the key became available to peek in the house we've been assigned. Like everything here it's old, and worn, cinderblock construction with "hospital-yellow" decade-old painted plaster inside, no furniture, no appliances, bare bones. It's not one of the larger or nicer houses here, but it IS one of the best locations for kids going back and forth to RVA activities. And we're all pretty excited about it, having our "own" place this soon in our stay is a huge gift. It will take a few weeks for some basic repairs and a repaint, but we're praying the hospital work crew is motivated, because after almost a year of slowly packing up, saying goodbyes, moving out of our home of 17 years, being in limbo, about six months now of suitcases and temporary stays . . the idea of moving INTO a house where we can stay for a few years is tantalizingly appealing.

To end the day well: notes for Jack and Julia from some of their beloved former teachers, bookends of their entire Uganda school experience, Miss Becky and Aunt JD and MIss Ashley and Miss Anna. Thanks for remembering their big transition today.

The Place of the Winds . . .

. . is the literal meaning for Kijabe. About 7000 feet high, perched on a steep escarpment overlooking the Rift Valley, below a pine-covered ridge, this is a sprawling ancient mission station. Hospitals, printing press, Bible school, nursing school, missionary kid school, dental clinic, maintenance facilities, water tanks, housing, housing, and more housing. Blending into a small town with its dukas, garage, post-office and gas station. A hundred missionary families I've been told, and I have no idea how many Kenyan families, working and living here. Most of the construction is cinderblock and cement, low-rise, though recently the space has been so squeezed that the newer buildings are three-story apartment complexes. One is under construction right next door, I can hear the whine of a saw and the pounding of hammers. But mostly I hear the wind. Rattling the windows, pounding against the walls, howling around the corners, rustling through the trees, day and night. Mid-day it eases up to a breeze, then gains momentum through the evening until the peak intensity in the darkness, when it sounds like we will be blown right off the hill. We shiver under layers of blankets as the cold air seeps through closed windows and flaps the curtains. Caleb says it is a soothing sound, like living next to the sea. That will take some getting used to for me. This is the same continent as Bundibugyo, but so far removed. We used to steam in the rainforest, mold and mud and heavy heat. Now we are high and cool and dry, brilliant sun and blue sky, expansive views and fine red dust. Ah, as Scott always says, there's a REASON a hundred families live here and two in Bundibugyo. Well, I know it's not all the climate, it's also the hundred years of sacrifice that have established this as a Kingdom fortress. I can see the cemetery from my bedroom window, and many of the graves are of the children of the early missionaries. Always a cost, and I respect the high price others have paid so that we can land here in a furnished apartment, to enroll our kids in a very decent school, and begin work in a high quality hospital.

But back to wind. The words for "wind" and "spirit" I think are the same in Hebrew. Certainly Jesus compares the Spirit to the wind in John 3. And the Holy Spirit's entrance at Pentecost is described with a sound like a rushing wind. But I always thought of those comparisons in terms of subtlety. The wind, unseen, moving, coming, entering. Two days at Kijabe and I see a whole new side to the Spirit as wind: powerful, a force that can not be stopped, cleansing, blowing away clouds of doubt, clearing the atmosphere for the penetration of the sun's warmth, wild, uncontrollable, inescapable. Sometimes harsh, sometimes overwhelming, sometimes destroying, making ready for the new creation. This is our place, for the next few years. Kijabe, the place of the winds. Praying the Spirit blows through us here.

New Year, New Life

Exploding firecrackers, claps, and shouts echoed in the darkness of Nairobi at midnight last night, just as we settled into our beds at the Mayfield Guest house. We're back, after a very straightforward and direct trip. Thanks for prayers for that--we all had seats, all our luggage made it, and though most of the guitar-case latches were undone by the time it hit the luggage belt the guitar was still inside, not something one takes for granted here.

First impressions: the quality of the sunlight. Coming from the winter solstice in North America, with its thin cool slanted rays of horizon-hugging sun, to the equator where the brightness is once again a wholesome and welcome surprise, full and intense light. Nairobi is uncharacteristically orderly for the holidays, little traffic. We dragged ourselves out at 10 am to Java House, and met no less than four different RVA/Kijabe-associated families doing the same thing. Nice. Though this does not feel like home the way Uganda does, there is hope. We ordered water with our breakfast, and the waitress asked, do you want that cold? Yes. (Though we would have liked a touch of warmth in our freezing almost-midnight showers last night.) Ahh, we are back in Africa.

Leaving America with a child still there is an excruciating experience, for sure. Strangers and aliens, felt more acutely than ever, in a sun-drenched land with the fragrance of cooking fires and the brilliance of bougainvillea. Heading out now to Kijabe, not sure of our next internet opportunity, but thankful for prayers that have carried us this far.

Out the Door . . .

 . . in another hour and a half.  Essentials going into the carry-ons now:  dramamine for travel sickness, pudding mixes and pine nuts and pecans and chocolate for cheering us through our first few weeks, a Bible and a change of clothes, and the Yale course catalogue for long-distance dialogue with Luke as he starts classes in early January, the SAT prep book in case I can get Caleb to prepare for the exam, and our new Kindle.  Scott has carefully weighed and measured our ten suitcases, keyboard and guitar.  Too scattered for closing words of wisdom other than thanks.  We would not have reached this moment without our army of pray-ers and supporters.  I moved through the five-month HMA in a fog much of the time.  It's been four years since my last set of America goodbyes.  Next post will be from Africa once again.  Prayers appreciated for:

-smooth travel (no snow here in VA but the world is still reeling from a week of storms)

-God's grace to Luke who is now being left alone in America for the first time, not yet 18, another two days with Grammy then off on his own for the Boston Winter Conference (Christian student meeting) Jan 1-5 and then back to Yale.  Lots of unknowns:  classes to enroll in, major to choose, something meaningful to do Spring Break and in the Summer, general survival. . . 

-God's grace to my mom, who has become accustomed to a rowdy houseful.  It's going to be quiet.

-Our purchase of a decent serviceable used truck in Kenya.

-Friends and sports and community and inclusion for our kids at RVA, and Swahili-learning focus for us in the first two weeks of January.

-That we would be a blessing to Kijabe Hospital and World Harvest MIssion as we move forward.

For the world's good, and God's glory.

Post-Christmas, Flee to Africa

Well, why not, after all, Jesus did.

At some point not too long after his birth, Jesus' parents received instructions to rise in the night and flee into Egypt. As if being IDP's was not enough (Nazareth to Bethlehem), a post-partum plunge into being refugees as well, crossing borders, heading to a far country, one with historical overtones of oppression.

We are also on the post-Christmas path to Africa. In 48 hours we will be boarding a flight to Kenya via Amsterdam, with our suitcases and new piano keyboard (thanks to grandparents), with our peculiar assortment of essentials: a few books (but mostly a Kindle!), guitar, and computers and clothes and chocolate. Another pass through the portal into the unknown. New community, new job, new language, new school, new unspoken rules and unwritten protocols, new methods for shopping for food or finding fellowship.

Vacillating between numb and stressed, anxious and thankful. Said goodbye to all the cousins today, my sister and her husband, who have generously cared for us and rearranged their holiday to be with us. Talked to my aunt on the phone, with the sobering awareness that her health and age could mean that by next visit, she won't be here. Visits from two of the three close family friends (almost-parents) I grew up with. And as we sort and throw out and tie up and book boarding passes, half our heart (or more) remains with Luke, thinking about next term's classes and his new job and how he'll spend the next holiday.

But when I take a deep breath I can see God's provision. He sent the magi with their portable valuable gifts, gold and spices. Cash for the journey and setting up a new home. And He sends us with ours, too. An hour ago we had a phone call from the missions committee of a church we've never even visited: Scott's parents ended up moving across the country to the same town as the mother of the girl one of his med school classmates married, who reconnected us to that classmate and wife, who took our story to their church, who met this last week and decided to give us two very generous gifts. One for our support, and one for our vehicle, in fact the exact remaining amount we were hoping to receive before we left. After a Fall of marginal finances, which carries its own sort of doubt we are very grateful for the generous outpouring of the last month. The magi don't come until the crisis is at hand. This is the way God works.

"The Dream Isaiah Saw"

Lions and oxen will sleep in the hay,

leopards will join with the lambs as they play,

wolves will be pastured with cows in the glade,

blood will not darken the earth that God made.

Little child whose bed is straw,

take new lodgings in my heart.

Bring the dream Isaiah saw:

life redeemed from fang and claw.

Peace will pervade more than forest and field:

God will transfigure the Violence concealed

deep in the heart and  in systems of gain,

ripe for the judgment the Lord will ordain.

Little child whose bed is straw,

take new lodgings in my heart.

Bring the dream Isaiah saw:

justice, purifying law.

Nature reordered to match God's intent,

nations obeying the call to repent,

all of creation completely restored,

filled with the knowledge and love of the Lord.

Glenn Rudolph

(as performed by the Washington Chorus and the National Capital Brass and Percussion, for a Candlelight Christmas at the Kennedy Center, our Christmas treat from my mom.  A minor key with the rumbling hope of redemption.  Merry Christmas Eve to all . . . )