More transition at Christ School

In 2010, we realized one of our longest-standing goals at Christ School … to place a Ugandan at the helm of the school as Head Teacher. We met this goal after much effort, anguish and prayer.

As with every year, 2010 at CSB was filled with highs and lows, frustrations and celebrations. However, in addition to the ups and downs, as Travis and I did our end-of-year evaluation we saw some signs of serious problems. Nearly half of our teaching staff decided to leave in December including two of our most senior teaching staff (one of which was a Deputy Head Teacher). The signs of collapsing morale and a lack of conviction for the Vision of the school led us to decide to make a change in the leadership of the school - 10 days before students were to report for classes. We did this - by faith - not sure how it would play out. God, however, had a plan.

Some of you may remember the story of a young Ugandan who became a Christian as a result of listening to Robert Carr and Alan Lee fight during a car ride over the Rwenzoris – and then repent to each other for how they had sinned against one another. That young man was Isingoma Edward. Isingoma (his name means "the first of twins") has been a colleague and partner to WHM-Uganda missionaries for 25 years. He's got tremendous leadership gifts and the requisite Masters degree for the Head Teacher job. When we offered Isingoma the job last week, his response was this: "I am ready and willing to do anything in my power to serve World Harvest Mission and Christ School." He has a fervent passion for knowing the LORD and making Him known. He firmly grasps the Vision Statement of CSB:

An academically excellent senior secondary boarding school

producing servant leaders

for the good of Bundibugyo and God's glory.

Please continue to pray for Christ School, for Isingoma as its new Head Teacher, and for Travis and Amy as they lead the Team and the school.

Please see the blog of Travis and Amy for a more detailed re-telling of this wonderful story of God's faithfulness.

HOPE

Scott here. Being “on-call” is part of the life of a physician. Last night, at Kijabe Hospital I was “on” for Medicine. Thankfully, though, because of our age and experience Jennifer and I are never the “first call” – that burden falls to our Kenyan Medical Interns. My front line warrior last night was Issac, a quiet diligent and quite competent young doctor. He called about 10pm last night for help. He was trying to clear the Outpatient Department so he could get some sleep. A dozen or so patients who had clocked into the OPD in the midafternoon were still waiting – and their patience was wearing thin.

So, braving the howling gales and pitch dark, I trudged over to Outpatient. I found a sleepy group of patients waiting for their turn to tell their stories to a doctor. None were critically ill, but obviously all felt ill enough to wait for hours to get an evaluation – and hoped for a cure. I sent a 6 year old for an elbow x-ray, admitted a 50 year woman who was scheduled for elective thyroid surgery tomorrow…and then came to W., a 55 year old woman with an “something in her stomach”. This lady stated she had a mass in her abdomen which had been moving around for the past FIVE YEARS. “Ma’am,” I said, “why have you decided to come to Kijabe Hospital TODAY – at 3pm in the afternoon – when you have been having this problem for FIVE YEARS?”

“Well, because my neighbor came to Kijabe and she got treated – and she’s better now,” she said.

“Where do you and your neighbor live?” I queried.

“Mombasa. I rode the bus from Mombasa early this morning.”

Yikes. That’s easily an 8 or 9 hour bus trip. This lady spent a considerable sum of her small savings, invested an entire day, and trekked halfway across the country, and ended up seeing me – hoping for a cure.

I’ve heard this type of complaint scores of times. “The worms are eating up my insides…the worms are moving around inside of me…there’s a stone growing up in this side of my belly…” Frankly, it’s a tough type of case to treat. Sometimes there is a diagnosis to be made; giardia, enlarged spleen from malaria, dysentery…and sometimes I can’t identify an explanation of the symptoms. In Bundibugyo, without any diagnostic tools, the latter was often the case. I began to feel a bit nervous – what if I can’t do anything for this lady? That will be horrible.

Well, I thoroughly examined her abdomen – no small challenge since there was about 6 inches of adipose tissue between my hands and her innards. I did detect a slight firmness and tenderness in her upper abdomen – so I decided to send her for an abdominal ultrasound, but that couldn’t be done until tomorrow.

“Ma’am, I want you to come back for ultrasound in the morning. Do you have anywhere to stay tonight? Do you know anyone around here?”

“No. I’ll just sleep here on this bench. I got no where to go.”

“Well…alright.”

So, I handed her a requisition for the ultrasound – and prayed that somehow she could be satisfied – with her care, with the outcome, with whatever diagnosis she ended up with.

I don’t know what happened. But I do know that I need to have that kind of hope, that surety that somehow God can make things all right – and I need to have a similar willingness to sacrifice all that I have in order to allow Him to do so.

Why we do it

A call, just before midnight. Outside, into the night, small flashlight on uneven dusty road. Dare to look away from the ruts and rocks, up at the Milky Way stretching brilliantly over Africa, undimmed, spectacular. Wind gusting in unseen trees. Then the hospital, the sleepy guard opens a gate, the empty corridors eerily quiet at last.

I bypass the nursery and ward and head straight to the newly constructed suite of operating theatres, where I change into clean clogs, mask, gown, hair-cover. There is the intern who called me, checking the warming bed and oxygen flow in the neonatal resuscitation room. I peek into the operating theatre next door, through the glass windows in the swinging doors, where the surgeon happens to be Scott. He let the on-call family physician know that one of his goals here at Kijabe is to become more proficient with C-sections, and at this moment he's well into what will be the second of three between 9 pm and 3 am. This woman, I hear, has severe pre-ecclampsia and gestational diabetes. She's been deteriorating all weekend and is now under general anesthesia in an attempt to save her life, and hopefully that of her 35-week (one month early) infant. No time to ask questions because I can see the smooth bloody purple curve of a head being pulled from her abdomen.

A few seconds later the baby is rushed into our room. I thought I heard a whimper, but when the scrub nurse deposits the infant on the warmer, I see no signs of life. He is limp. Not even a gasp of breath. The intern and I rub his back, talking to him, willing him to breathe baby breathe. We dry his slippery brown body and hold the oxygen near his face. I feel for a pulse, and feel nothing. Start bagging, I tell the intern. NOW. The intern places a mask over the baby's face attached to oxygen, and very effectively delivers breaths, a little too fast but that's to be expected in the stress of the situation. I have my stethoscope out, hear good air entry, and now the beginnings of a heartbeat. As we reach the one minute mark, we pause and dry and rub again, trying to wake him up. Apgar 5 out of 10, he's pink and has a good heart rate thanks to the initial resuscitation. Bag another half a minute. Now his arms are moving, he grimaces, and weakly cries. We change for dry cloths, blowing a little oxygen by his face as he now decides to make the transition to life. We check over his whole body now that we aren't focused on the basics of survival. He's beautiful.

Mom is still unconscious and we're not so confident of this baby's strength, so we decide to take him back to the nursery with us. I gather him up in my arms wrapped in surgical cloths, warm and solid, and walk him through the sleeping hospital into the blue glow and steamy warmth of the NICU. Since his mom was diabetic and he's premature we have to watch his blood glucose level, and put him on IV fluids and oxygen and a monitor for a day. But today he's fine, and now I think as a mom more than a doctor and convince the nursery team (who would rather have him attached to tubes and under their eyes) to let him go back to the maternity ward and bunk with his mom, so he can start breast feeding. She's slowly improving, delivery being the cure for toxemia. In the afternoon I check back and am relieved to know he's fine.

An hour or two for the mom, a few minutes for the baby, the difference between life and death. The availability of a safe and competent C-section for her, the immediate response of warmth and a kick-start of breathing for him, and now the prospect of continued life instead of two burials. Most hours aren't so clearly beneficial to anyone, so it is something to savor, to witness pink warm life creeping into an infant body. Of course in the case of Kijabe, this all would have happened without us, there are many doctors here. It just happened to be on our watch this time.

Here is my secret: I love being on call. I like the quietness of the hospital at night, the focus of only one operation, one baby in need, one admission. The thinning of the crowd, the direct contact with one family or one intern. The friendliness of the nurses away from the pressures of the day. The slipping back out into the night when all is settled, the brisk walk back to a sleeping house. The momentary assurance, that's why we're here.

Moving . . moving . . moved

Writing, at last, from home.  Yes, we now live someplace (renters, but it feels like ours).  A house with a yard and a porch, and two bathrooms, and fresh paint, where two sacred ibis were just picking their way around the wilty dry yard as Julia and I searched for a few flowers to brighten the table.

Table?  Yes, we have a table too.  First, mid-Wednesday, we had six mattresses and a stove and fridge, and decided that was enough to justify occupation.  So we moved over from the furnished apartment to sleep on the floor that evening, a much more exhausting process than I anticipated.  Had to go back and make pancakes at the first place that night since I had nothing to cook with, though there was a stove to cook ON.  Then Thursday we carried in the dozen trunks we had stored in two families' attics here, caked with dust, filled with the fragments of our life in Bundibugyo.  Way too many books, a few pans, our favorite dishes, electronics, kitengis, games, a quilt, tools, tents, Christmas decorations and Easter baskets.  And books.  We unpacked them into stacks all over the empty floor, and slowly sorted and put what we could into the few closets here.  Then Saturday Scott went into Nairobi once again, and sent back two small chests of drawers and two chairs.  Furniture!  Then he returned with the curtains we had ordered, and Caleb and Julia painstakingly attached them to the drapery hooks at every window.  Privacy!  Color!  

Saturday evening the long-anticipated six beds and two couches came, Africa-style, on the back of a little white pick-up truck.  Not exactly what we had in mind when we paid for the transport . . . especially since the light-colored upholstery was left exposed to the dust of the road, and marred by the filthy ropes used to tie it down.  It seems that these couches are my thorn.  Because I really like them in spite of all the hassle, they look a LOT better than the fabric sample made me believe, so I have to keep being reminded not to put my heart on them too much.  Today the little truck returned with the dining table and 8 chairs.  By the end of next week we're hopeful for three simple desks (tables really) and two bookshelves.  

So there you have it. With all the creative pottery (Luke) and woodwork (Caleb) displayed on our one shelf, with our throw pillows (team via Karen as we departed), with sheets and pillows and even two blankets (it is COLD at night, the first night we were shivering and broke out the sleeping bags from our camping supplies), with places now to sit and eat, this place looks like a home at last.  

A closing story on God's provisions.  When I unpacked the trunks Thursday, I realized that though I had three pans and a skillet, I had not one utensil with which to stir.  I was seriously regretting leaving so much behind.  Then Kimberly our fellow-WHM missionary texted that she was coming to the dentist at Kijabe and offered to bring something, so I asked her to pick up a spoon, whisk, and spatula, which she graciously did.  I mentioned this Friday afternoon to one of the short-term visiting doctors from New York, and he brightened up.  Come by our place, he said, our church had a "kitchen shower" for the missionaries and we brought an entire suitcase of kitchen supplies.  Coincidence?  I think not.  I did not need to be asked twice . . within and hour I was knocking on their door.  I could have almost cried when Elaine gave me two bright aprons, brand new dish towels, measuring cups and spoons, a few more utensils, a couple sharp knives AND a sharpener, even a vegetable peeler and a pastry cutter.  Many of the things I left behind, being given back to me new and spiff and free.  It's the kind of small detail that God delights in working out, to remind us of His intricate mercies.

Today feels like a corner turning, the end of leaving (Bundibugyo, team, our normal life, our HMA) and the beginning of being present in this place where we've been moved.

More Redemption . . and CELEBRATION

More than three years ago a young lady came to our church at the urging of her Sunday School teacher, who happened to be one of my good friends growing up. He had urged her to apply to teach missionary kids in Uganda when she graduated from William and Mary. Little did we know that Sunday morning that Sarah would become like a member of our family. Meanwhile another young man was graduating from another William, this time without the Mary, Williams College. He applied to spend 18 months in Uganda with a possible interest in medical school. We took him on, partly because we were anticipating another young single guy whom we didn't want to be alone (who never came, ironically leaving Nathan alone most of his term). Little did we know then that Nathan would also become and integral part of our family and life. Sarah and Nathan served wholeheartedly in Bundibugyo during some rough years for the district, and for our team, and for us. They both did amazing jobs. But even more amazingly, they found God drawing their hearts towards each other. It is pretty ridiculous to even think about "dating" on a team where the singles function like siblings, where every moment and action is observed by a curious community, where there isn't a restaurant within hours, where privacy is culturally suspect. And where each of us is stretched to the limit. This is not a set-up for glamor or romance. And when Nathan and Sarah did realize their hearts moving in this direction, they bent over backwards to be sensitive and submissive. Even so, there was a cost to the other singles on the team, as well as their own cost. When Sarah finished her term Nathan remained, and they made the excruciating decisions about medical school/masters in public health options while they were 7,000 miles apart, taking some risks (waiting list) that panned out to put them in the same city.

So it is with more than the usual rejoicing that we received the news on Saturday of their engagement. Sarah and Nathan will be married this summer! I believe this is the fifth American wedding to come from Bundibugyo, two other couples who met there (Rick and Wendy, Eric and Joy) and two who met at MTI (Natalee and Wes, Rachel and Craig) . . . am I forgetting someone?? Bundibugyo is a place where marriage has fallen far from God's creative and beautiful plan in Genesis. Unions are temporary, sequential, financial, and too often end in violence or abandonment for women. It is NO SMALL THING when a marriage actually grows from this soil. It is the kind of amazing, upside-down, Kingdom-only work that God does to surprise us.

Nathan and Sarah remind me that we serve a God who is making all things new. Who prepares a celebration so wonderful, that a marriage supper is a weak analogy to help us anticipate the glorious reality. We rejoice with them, and pray for faith as they move forward in their life together, becoming a redemptive blessing to this world.

Congratulations to our dear friends!

Redemption and Rejoicing

The RVA student who has been in a coma since Saturday woke up this morning! After four days of worrisome unconsciousness as malaria parasites plugged up the small blood vessels of her brain, the prayers of the saints and the careful treatment of her medical team finally pushed her back from the edge of survival. She is quiet in that unsure sort of way, but looking us in the eye, and smiling.

Scott and I have been asked to be the first-line contact for the student health as school physicians starting in March, a sideline to our regular jobs in the hospital. We've pitched in a little this week due to crisis, not only the crisis of the young woman with cerebral malaria, but also the epidemic of 72 other students (15% of the school) out with flu and gastroenteritis. So we've felt deeply, both as parents and as doctors, the gravity of this case and the nearness of disaster. Please pray for us to have insight and caution and care with the precious burden of other peoples' children. If there is any group of kids that would be under attack, it is this one, as they represent the easiest way to remove a thousand missionaries from service.

So another small redemption occurred in student health, in the midst of the sea of flu a young man who had persistently been febrile and occasionally sprouted an impressive urticarial rash, which the excellent nurses had the foresight to photograph in case it was gone by the time we saw him (it was). Turned out he had gone rafting on the Nile and boating in Lake Victoria a few weeks ago. And we remembered the time Julia and Caleb BOTH had classic Katayama Fever, the relatively uncommon phase of acute schistosomiasis; it took us a week to figure it out a decade ago but this time we realized immediately what was going on. A little piece of suffering redeemed for someone else's good.

There is much relief and joy on campus today for the daughter that was almost lost and now is found.

The illusion of choice

There are many heavy things going down here right now, spent a couple of hours praying at the bedside of a missionary kid in the ICU yesterday. Every missionary parent's worst nightmare. But I'm way on the periphery of that story, and too tired to do justice to the pain of it. And so I'm going to write about something completely frivolous. Because life is like that, actually. A crisis can seem all-consuming, but the rest of the world continues on while someone's mother holds a pale and unresponsive hand.

There are many heavy things going down here right now, spent a couple of hours praying at the bedside of a missionary kid in the ICU yesterday. Every missionary parent's worst nightmare. But I'm way on the periphery of that story, and too tired to do justice to the pain of it. And so I'm going to write about something completely frivolous. Because life is like that, actually. A crisis can seem all-consuming, but the rest of the world continues on while someone's mother holds a pale and unresponsive hand. We were called this weekend by our Faith-Based Furniture representative. I suppose our mustard seed of faith just wasn't enough, because he wanted us to come back and choose a different fabric, seeing as the one we had selected was "finished". In Africa this word "finished" accounts for a lot of what you might THINK you had the power to choose. I was not happy about this since the couch was the primary item of color around which we had planned EVERYTHING else (curtains in particular, and the neutral "almond sand" walls. When we were in the shop originally, we had looked through several very professional appearing books of fabric samples, and chosen a woven/textured/burnt maroon. It was very nice, intended as the focal point of the room, of the house really, and not of a dirt-showing hue either. I was caught up in the wonder of this possibility: me, who had not been called upon to make a decorating decision since I got to select the paint and wallpaper for my room when I was 13, designing a living space.

When we went back to the shop this weekend, however, instead of the spiff books he showed us four little scraps of fabric he had brought from the market. Bright eye-popping orange, dark brown, gold, and a khaki/tweed. It slowly dawned on me that the fat books of samples were probably donated/stolen/whatever from some American showroom and bore absolutely NO RELATIONSHIP to the actual availability of such fabrics on this continent. They were a comfort to the customer, the illusion of choosing maintained, while the carpenter knows that he'll just take anything in the same universe of fabrics he can find. So since I had chosen a woven texture, he brought me four samples that were indeed a woven sort of fabric but other than that had little in common with the original. We just couldn't see the bright orange being compatible with anything, the brown was dull, the gold clashed with the curtains, so sadly we had to give up on our little hope of beauty and settle for the tweed.

I remembered the nights we used to go to the Mountains of the Moon when it was a run-down crumbling post-colonial hotel and the only restaurant in many hours any direction. They would bring out the menu, and we would deliberate over our choices, wanting to make the most of our one eating-out opportunity for the month or the quarter . . .then the waiter would come back, and not matter what you ordered, he would say, "Ah, sorry sorry, but the ______ it is finished". Finally in frustration you would just jettison the menu and say "So what DO you have?" And even then, when he would say "roasted chicken" what he meant was, there is a live chicken somewhere on the hotel property that could be found, chased, killed, plucked, and cooked in merely two or three hours.

So, the illusion of choice, given to us picky bajungu, we who like to think we can control, we can steer away from tacky furniture and clashing colors and tasteless food, we can select that which is beautiful and delicious. And we can select it, we just can't have it.

This treasure in earthen vessels

Whenever a Bible passage comes my way from two directions simultaneously, I know it is time to pay attention.  This week the day my New Testament reading landed on 2 Cor 4, a friend from America wrote to say she was praying that for me.  So I have just stayed there the last few days, soaking.  

For we do not preach ourselves . . .oh, right.  I've been so discouraged by my inadequacies, running smack into the mountain of things I don't know.  But I'm not here to prove that I'm competent or smart or worth listening to.  I'm here to point people to Jesus.  Easy to forget in the more formal "consultant" teaching and pontificating role here at Kijabe.

But we have this treasure in earthen vessels, that the excellence of the power may be of God an not of us.  We are hard pressed on every side . . . Realizing our fragility and emptiness, our clay-pot-ness, does not mean smooth sailing.  We're still pressed.  As always Bundibugyo is the epicenter of hard pressure.  January means that the school year is about to start, and this has probably been the roughest pre-school month ever.  The Johnsons have had to make some hard decisions about staff in a culture that is indirect and non-confrontational and secretive.  That's their story to tell, maybe in a week or two when things settle out, but it's part of our story still too.  Our hearts are there, and as earthen vessels we trust God to fill us with spiritual wisdom in our advice from afar.  Today there was a pretty firm confirmation that something we sensed in prayer a year and a half ago God might do for the school will come into being.  Perplexed, but not in despair, persecuted, but not forsaken, struck down, but not destroyed. . . 

Therefore we do not lose heart . . . Paul speaks of the unseen weight of glory that accumulates through our light affliction.  Perhaps the church in Mundri is beginning to hope for this, sensing that their suffering prayers have led them to victory over war and destruction and hate and fear.  The initial tally of the referendum shows 98.6% in favor of secession.  

That grace, having spread through the many, may cause thanksgiving to abound to the glory of God . . Last night a state of grace descended upon our house, for no reason other than the faithful shouts of "the many" spreading grace.  Caleb invited two classmates for dinner at almost the last minute, I had enough food, candles were lit, my experimental cooking turned out well with a little borrowing from neighbors, there was fellowship and camaraderie.  It was the most relaxed and "normal" we've been yet.  So, thanks, and keep praying, particularly that the Johnsons would get a similar evening at the end of a stressful weekend.

For the things which are seen are temporary, but the things which are not seen are eternal.

paragraph one to post below . .

(you know you're in Africa when you post this thing five times and the first paragraph keeps turning out blank??)

. . the school sends an email to all the parents warning us that a hyena was spotted (no pun intended) on one of the football fields at 4 pm yesterday. I am not making this up. We are instructed to warn our children. To do what, I'm not sure. I reminded mine of "The God's Must Be Crazy" and suggested holding a tree limb over their heads to make them look more intimidating. Seriously though, it is a bit frightening to think of a hyena prowling out there in the dark and windy night as my kids walk back and forth to evening programs at school . .

You know you're in Africa when . . .

. . the school sends an email to all the parents warning us that a hyena was spotted (no pun intended) on one of the football fields at 4 pm yesterday.  I am not making this up.  We are instructed to warn our children.  To do what, I'm not sure. I reminded mine of "The God's Must Be Crazy" and suggested holding a tree limb over their heads to make them look more intimidating.  Seriously though, it is a bit frightening to think of a hyena prowling out there in the dark and windy night as my kids walk back and forth to evening programs at school . . 

 . . and when the last admission of the afternoon is a 6-day-old vigorous baby with a bilirubin of 27.  That's high.  That's the level of jaundice that edges into the brain-damage range (and lest we forget that the risk is real, we have another child on the ward who is neurologically impaired, which made sense when I saw his old chart and his admission as a newborn for a bili of 39).  So the nursery is gearing up tonight for the second exchange transfusion in a week, a procedure that is almost unheard of in the USA.  Why?  The baby was seen at two days of age and sent to the lab for the bili test, but it took the family 4 days to come up with the funds.  So a problem that could have been resolved by light therapy (pretty cool, there is a blue wavelength that changes the toxic bilirubin into an excretable form, so the nursery glows an arctic blue in the steamy heat as infants wiggle under the eerie lights, like so many roasting chickens) now becomes a problem that will require a time-consuming and dangerous process of removing the baby's blood and infusing donor blood, a few cc's at a time, until twice his estimated blood volume has been exchanged.  Stoic and inefficient and sacrificial all at the same time, Africa.

 . . and when I notice one more mom with two kids in the ER at midnight, a fussy one on her back whom I assume to be the sick one, and a 4-ish year old passive little boy standing in front of her.  I ask what the problem is, and she lifts the standing boy's shirt to reveal a fleshy lump protruding over his lower spine.  A big one, soft and spongy.  In fact it looks like a meningomyelocele, but those are usually fatal if not repaired as a newborn.  But it must be, because she has an appointment slip for the neurosurgery clinic, and explains through staff that she lives in an IDP camp at some long distance and though she left home this morning to come to the hospital, she did not arrive until the clinic was closed.  She had no nearby relatives or friends, so there she sat.  The nurse in charge of "Casualty" matter-of-factly said "we must accommodate her so she can see the doctor tomorrow."  Once again, that stoicism, not making any fuss, just sitting there in the midst of the emergently ill, because it was the only place open by the time she could drag her two kids here.

 . . and when dinner preparation includes an evening brisk walk to the nearby town where a half-dozen ladies sit in a shed-like enclosure, each with her own table of exactly the same fruits and vegetables set out for sale.  I am almost always the only customer when I enter, and so far my strategy has been to try and buy at least something from each table, keeping everyone happy.  I try to use my Swahili, which only confuses them, they are quite used to white people and English being this close to the mission station.  I take my cloth bag and fill it with 5 avacados, 3 mangos, a squash, broccoli, two tiny heads of very dirty lettuce, a cluster of cilantro (!), a dozen or so tomatoes, a few potatoes and carrots, two zucchini, and two apples (!), spending about seven dollars I guess.  Walk ten minutes back home and put a chicken I bought from a local lady into the oven (dead and plucked though!), then the sliced vegetables.  Feel semi-competent with my Alice Water's Art of Simple Food meal until 45 minutes later I realize the propane tank is finished, and my oven is barely lukewarm.  We locate a spare tank, start the dinner cooking again, as kids hover starving.  I have one little end of a loaf of bread left and decide to toast the five pieces to accompany the chicken and veggies.  I slide them under the broiler, get distracted, until I notice the entire apartment filling with smoke.  Panic.  I open the broiler and there are five flaming balls of charcoal.  Jack is so impressed with the fire he does not even feel bad about the lack of bread now.  Finally we sit down to eat, and I realize how even a simple meal is not simple when everything is still unfamiliar and uncertain. and involves languages and interactions and equipment and disasters.

 . . and when I sit down now at 9 pm and try for about half an hour to send this post, without success, give up for the night,  and think, there is no place I'd rather be, than Africa.