International Women's Day

On this day, we recall that it is more likely a girl in South Sudan will die giving birth than graduate from high school.

On this day, we reaffirm the Gospel that calls out good news for the women of Sudan and Uganda and Kenya and Burundi and beyond, the hope of dried tears and justice, the comfort of real love.

On this day, we honor women like Melen Musoki, wife of the late Dr. Jonah, who three years ago this day gave birth to their only son, months after he husband had died of ebola. She labors on with her nursery and primary school which provides a head start education to many of our friends and colleagues in Nyahuka, with her five daughters all in various boarding schools, with her management of the family farm, with her tenacity to protect her children from the greed of relatives who would cash in on Dr. Jonah's compensation.

On this day, we stand humbly beside the moms in the hospital, those that hover in this grey realm of having brought life into the world but unsure how long it will last, those sleepless patient women, who gather courage in the midst of foreign beeps and screens and monitors and tubes, to touch their babies. The lady with AIDS whose rocky post-partum course dried up her breast milk, whose husband abandoned her and her older children, who labors to feed her precious baby D. The lady with what looks like metastatic ovarian cancer who is too weak to get out of bed, but requested that the staff slip her feisty little preemie P out of her incubator and wrapped in warm blankets for a glimpse today. The eighteen-year-old with cute braids and a simple smile who cares for her devastated toddler, his brain severely damaged, his face half-eaten by infection, on morphine and fluids for comfort, death inevitable but slow. The mom of Baby N who spent her 95th day in the NICU today, plugging along with feeding and growing, up to 1700 grams (3 3/4 pounds). The new mother of twins, delivered too-early, one pink and calm and perfect, the other fighting hard for her life, ribs pulling against non-compliant lungs, tiny fists batting against her oxygen tubing. All these women, every two hours, day and night, around the clock, coming in to sit by their babies' incubators and cots, to squeeze out life-sustaining breast milk and drip it through naso-gastric tubes, or to hold the larger babies and breast feed them.

On this day I remember the international team of women who have been friends and mentors and prayer warriors and encouragers. Who cooked food for our family, who planned school or taught it for my kids, who read our blog and cared as if it really matters, who planted flowers to welcome us back from furlough or sorted umpteen ages and sizes of baby clothes when I was overwhelmed, who stepped in to care for our team and kids in crisis, who listened and prayed and biked and walked with me, who showed up to work in chaos so I wasn't alone. Women from Uganda and America, and a few places in between. Nurses, teachers, counselors, missionaries, neighbors, friends. And most especially, my mother and Scott's.

On this day we ponder the wholeness of the nature of our God, expressed in the paradox of male and female, a celebratory dichotomy and an essential equality.

And lastly, on this day, we cook breakfast and sort clothes, we examine patients and xrays, we chop vegetables and sweep floors, we answer homework questions and wash dishes, because it is, after all, women's day.

In Praise of a Home

I am wary of feeling at home.

Which is probably only to be expected, seven thousand miles from where I grew up, and a country away from where I spent the most significant portion of my life since. And after leaving our only home as a family. And after being on the road and in transition for the better part of a year. And ascribing to a theology summed up in the antique cross stitch over my Virginia bed: Heaven is my Home.

But it is creeping into my heart anyway, in spite of my guard. I must confess, I love this little house at Kijabe. As I write now I've just cleaned up from a Sunday post-church chocolate-chip-pecan waffle brunch with neighbor's kids whose parents are traveling, a lovely hour of family and fullness. Fragrant, exuberant lilies and bright yellow zenias explode from a beautiful blue vase that Pat gave us: a perk of living near the massive flower farms that supply Europe from Africa, one can buy spectacular flowers cheaply, year-round. My dining table and chairs match, an island of harmony. There are wide bright windows that overlook a yard with a poinsettia tree, sparse dry-season blooms and grass. We have two comfortable couches that turned out twice as nice as I expected. The floors are a wooden parquet or tile, no exposed rough cement. All three kids are quietly reading or studying or playing guitar, in three separate bedrooms, instead of piled on top of each other. We have hot water for washing, electricity most of the time, and the most awesome washing machine for clothes, with a sturdy line out back for drying. We have two bathrooms for the first time ever, a perk when we're all trying to get out the door by 7:30. Not a single rat spotting since we moved, nothing worse than the occasional roach or harmless small spider or fly. I'm told there are no snakes at this elevation, either. Books and pottery on the shelves, and photos of Uganda and family on the walls. I really like it.

Yesterday, I was walking back from early morning Saturday rounds at the hospital. . . .I had just spent a couple of hours in the NICU, making the difficult decision to pursue comfort measures and time for her parents to hold her rather than aggressive intervention for an infant born with such severe hydrocephalus at another hospital that the OB's had to literally pop the balloon of her head to get her out and save her mom. This sweet baby had minimal and abnormal brain tissue on CT, and after a week of care was only getting worse, with periods where she stopped breathing and had to be resuscitated. We have one of the premier pediatric neurosurgeons in the WORLD here, but even he could not recommend any surgical help. I had also just gone over plans for another infant with another experienced pediatric surgeon, this one born with no anus and a confusing perineum, unclear male or female. On another baby we were increasing our oxygen and pressure to maximum levels, her lungs and body damaged after being born at home with a difficult labor, choking and aspirating, limp and uncrying, and five hours later landing in our care with a temperature of 33 degrees (that's very cold) but alive. We have darling preterm twins whose mother was just released from the adult ICU herself, narrowly surviving and ecclamptic pregnancy. We're filled pretty much to our capacity with 17 babies in a small space. Scott ended up managing the adult ICU for part of the weekend too, when it turned out that all the docs who usually cover (the most experienced handful here) had an unusual intersection of travel and he was the last man standing. . . . Anyway, as I walked back home about 9 am, the sun was warming the air. I had handed over to the on-call doctor for the day. I looked up and saw our little cream-colored house, waiting.

I was glad at that moment to have been a small part of the care of all these little lives, and glad to be back out in the sunshine, and glad to have a home to return to. My heart was filled with thanks because we had just talked to Luke on the phone, and his Global Health Fellowship for the summer was approved by Yale. He worked hard with his friend Thomas at Princeton to design a research study, to be interviewing Maasai in two areas of Kenya about their traditional medicines, so that medical personnel can be aware of possible effects of these herbal treatments when the Massai come to the hospital. It is a good, solid project, but my heart was particularly relieved because he is now funded to return to Africa! It is odd to be living in a home that 1/6 of our family has yet to even see. So the news that he gets to come back here, even gets his costs covered to do so, was sweet.

Which then made me wonder, why should I be surprised that God gives me a home, and brings my family to it? Why do I keep wondering when it will all fall apart, again? How do I revel in this place of beauty and significance, and yet not hold on to it too tightly? Another missionary mom rode to the girls' football game with me this week (I drove to Nairobi, thanks to Scott's prompting, another milestone of actually beginning to LIVE here, but I digress). In the car she expressed the same thing, having moved here from a very harsh and hostile environment in northern Kenya, from a place where the local kids threw stones at hers to a place with a good school and kind people and useful work and kids on sports teams that we can cheer, she asked God, is this OK? Are we allowed? Yes, I thought, i am asking the same thing. Are we?

As I said, I'm wary. I believe in the all-out lay-down-your-life mode of going through this world. I believe in eternity, and the perspective it lends to daily life in hard places. But I also believe in a Father who does not give a stone when we're hungry for an egg. For this season, He seems to be allowing us to take a deep breath, to learn from others, to have friends, to sit around a table with our kids, to have curtains that match fresh sheets and cozy beds. He seems to be giving us a taste of the eternity we long for, allowing for our finite, concrete, in-body experience.

To be at home.

Thirteen

Today is Jack's day . . . and it seems to be a popular one with Kijabe babies, there were so many being born this morning that the nurses were scrambling to get the ID bracelets attached to their ankles as we stacked them up two to a bed where they lay blinking and waving, waiting for their mothers to revive and hold them. We began our celebrations this morning by breaking out the final tiny 4-ounce jar of apple butter that our kids smuggled through security in their backpacks, to have with our biscuits. By 7:30 the kids were heading up the hill to school and Scott and I to a staff meeting. As I tried to engage in the discussion of appropriate triage of patients, and the structural implications of the nursing school upgrading from a diploma to a degree program under Scott University, I was thinking of how to get my NICU work done in time to finish party prep, and looked around the room. There are three other women consultant-level doctors here on a staff of about 25 to 30, but none come to meetings, and none are really in my position (two are young Kenyans who are married and mothers-of-one, and one is a single American surgeon). It hits me: I'm a mother of four teenagers, as of today. And it's as demanding in its own way as being a mother of four toddlers.

Jack decided to invite his whole basketball team to lunch. There are ten boys on the Jr Hi "A" team, and they finished their last regular game of the season undefeated this week. I am so thankful for this natural grouping for Jack, a healthy way to spend almost every afternoon with a core of classmates. I never dreamed he'd spend his 13th birthday with a basketball team, since he just learned to play a few months ago! They came down the hill shouting and teasing, very comfortable with one another, and thanks to help from my trusty houseworker Abigail and an hour-off from my trusty paeds team, I was ready. We turned ice cream, and ate chili and corn bread, then celebrated with a chocolate cake. Noisemakers, balloons, sodas, laughter, stories. It turns out that Jack was by far the youngest, 2 boys have been 13 for a while and the rest are 14 and even 15, even though they're all a similar size, there is a wide range on the puberty issue (sometimes I try to remember why we let him be an 8th grader, but it's complicated. Should have thought harder about sports). An hour later they all bounced off the walls and into each other and back up the hill to school. It was a fun party, and the first time Jack's had such a large group of peers to celebrate with. This evening we had a family gourmet dinner (Jack does love his food), much quieter than the wildness of the junior high boys. Phone calls from Grammy, the Bundi team, and Acacia. Emails from a CSB classmate (may you live to blow a thousand candles), and absent brother Luke.

Jack at 13: still growing into his body, reckless abandon in all pursuits, intensity, messy, curling up with a book, avid fan of premier league football, affectionate, teaser, handsome, attention-seeking, anxious at times, friendly, popular, loud, sprawling, adventurous, emotional, spiritually sincere, still mostly kid with hints of the young man shining through, sharp and creative with unanswerable questions because he sees things in his own unique way, smart and artistic, unsure of himself, low frustration tolerance, a drive to win. A remarkable person, who surprises and enriches us every day. I am thankful for that day 13 years ago when I walked into Kijabe hospital with Scott as my doctor and delivered him on the very bed where my patients today were born.

Sixteen

Caleb, sixteen, and sometimes sweet (are boys allowed?). Thoughtful, affectionate, affirming. Quiet, needing down time to play guitar, to listen to music. Never quite enough sleep. Aggressive on the field, coordinated, strong, wiry, endurance. Aware. Thankful. Sometimes a loner, not one to bend to the crowd. Keeps his thoughts to himself mostly. More likely to just shut the door and do the work than to complain or ask for help. Quick wit. Sharply funny, in the right mood could be a stand-up comedian, the eye for the incongruous. Still silly.

Today Caleb turned 16, right here where he was born. All three meals a celebration, punctuating the normal work of the day. Culminating in five friends joining us for tacos, chocolate cake, and home-made ice cream (inaugurating the hand-crank freezer that took up the better part of a trunk, 10% of our luggage allowance!). Crazy noise-making horns and bubbles so the HS Juniors could revert to their true 5-year-old souls.

Birthdays wipe me out, carrying the weight of expectation through the day, to push to make it special because I want to honor the person I love. But the rest of the world turns on, punky babies are born and forget to breathe properly, children vomit, mothers are anxious, labs come back abnormal, xrays need reviewed. So the day becomes a struggle to be two things at once, creative at-home cake-baking mom and responsible in-the-NICU doctor, all accentuated by the rigid time-keeping of a boarding school where the friends who come for dinner have to be at dorm study halls at 7, though mercy was reluctantly granted for a 15 minute lateness. Add in a basketball home game for Jack, Scott and I tag-teaming on cooking and cheering and hospital calls (alone I NEVER would have made it). I suppose that tension between the worlds of work and home started back with the first giving-birth and will continue until they are all grown and launched, and beyond.

A Burundian Story

Burundi emerges in folds and ridges, green, rumpled steep, then a snaking river that twists into one of the deepest and longest lakes in the entire world. Rice paddies and dusty roads and then the tarmac of the small international airport, we are in Bujumbura. A single rusted Air Burundi jet sits neglected by the old terminal, but we taxi past to the shiny silo towers of the new one. We stumble through the French arrival forms and smile a lot. Our bags are x-rayed as we LEAVE the arrival area, which sort of fits the general tone of isolation and suspicion. It's not an easy country to get into. Being from Appalachia, I wonder at the parallels, mountainous terrain where clans cling to coves and hillsides and remain inaccessible and independent.

Background: Burundi was colonized by the Germans, but not extensively. After WW1 the European powers transferred Burundi into the hands of the Belgians, until independence in 1962 (same year that Uganda and I were born). Though all three "tribes" speak the same language, the Belgians in both Burundi and Rwanda favored the Hamitic-descended Tutsis over the Bantu-descended Hutus as chiefs and administrators, and left the forest-dwelling BaTwa (pygmies) out altogether, setting up over decades the tensions that erupted in the 70's and 90's in genocide. Central, inland, Africa was one of the last places to be reached by missionaries as well, with the first protestant missions arriving in the 1930's. The small bands of North American and European evangelicals forged schools and a few hospitals with an unusual spirit of interdenominational cooperation. But years of war, destruction, the exodus of expatriates, left these missions devastated. In the last five years the missionaries have begun to trickle back, following their Burundian colleagues, a dozen or two now resident in a country of 8 million people. A church leader who spent years in exile in Nairobi started a school while there for the Burundian refugees, and as peace was established moved it back to Bujumbura as Hope Africa University. This university has grown from a few hundred to a few thousand students, with medicine and nursing (and Bible and education and engineering, a radio station, clinic, library, computer lab, dorms, etc.). Their motto: Facing African Realities. And the founder, Bishop Ellie, prayed for 15 doctors to come and establish a clinical training hospital at Kibuye, 2 hours into the hills, right smack in the middle of the country, where students in the nursing and medicine programs could be mentored and taught, discipled and molded.

Meanwhile, a group of young men and women befriended each other during their medical school years in Michigan. Two were MK's who grew up in Africa. All were committed to giving their skills back where they were most needed. The ophthalmologist and the surgeon married their school-mate sweethearts who had become teachers, and the family medicine doctor married the obstetrician, and all three couples joined the Samaritan's Purse Post-Residency Program designed to get young doctors to Africa for two-year apprenticeships. They called themselves "The McCropders", a synthesis of all their last names, for ease of reference. They were sent to Tenwek, a mission hospital in Kenya, where they added a medicine-pediatrics and an ER doc to their number. Six doctors and two teachers; 3 couples and 2 singles; 6 babies later . . they began to ask God where He would have them serve long-term. It had to be a hard-to-reach sort of place, needy, with a focus on teaching medical students. They explored several options, including Hope Africa University (through a friend-of-a-friend who read their blog and thought they might fit).

And while this was unfolding, they came in contact with WHM because the church they all attended in medical school had been impacted by Sonship. We arranged a lunch meeting a year ago when we were in Kenya for the CMDA conference, and kept in touch. As the Burundi option became more appealing to them, they looked for a mission agency that would be interested in sending them. As Scott moved into the role of Field Director, the evaluation of this potential new work became part of our job. Which is a lot of background story on how Burundi, the McCropders, Hope Africa University, the Myhres, and World Harvest Mission all ended up entwined this past week.

Word Pictures: Burundian drummers, tall, red-robed, springing handstands and jumps and claps, flashing sticks, chanting hymns, wild enthusiasm and rhythm. The winding smoothly paved road that snakes up from the lakeshore capital and into the hills, clay-tiled roofs, fields and villages flying past. The carefully handwritten lists of tests and patients in the laboratory, malaria, malaria, malaria. A peek into the operating theatre where a visiting short-term retired missionary doctor was amputating a young girl's severely infected arm, medical students watching, drapes and blood and a clutter of equipment. Bright kitengi-clad mothers lined up on the benches, waiting for care. Wide boulevards in the capital, cobblestone side-streets. The multi-story Hope Africa University buildings, solid and fresh, rising from the dirt, disgorging hundreds and hundreds of young people from multiple countries in Africa, with their jeans and braids and cell phones and chatter. A peek into the grocery stores, sparse goods neatly arranged, too much space. The noisy clatter of the University dining hall where we chat over lunch with professors from Congo and Canada. Fresh cement, the whine of wheelbarrows and clang of hammers, more buildings under construction. A young boy in traction for a broken leg, his x-ray hanging over his bed, so poor in quality one can hardly tell the bone from the background. The thrumming of a grain mill where the church manufactures a nutritious porridge for malnourished children. Walking down the dirt paths of Kibuye, imagining houses for the team somewhere back in the weedy perimeter. Dredging up new Swahili skills when the taxi driver kept stopping and changing direction; hearing the echos of Lubwisi in KiRundi; resurrecting college French as others spoke. Whipping wind and rain as a massive storm moved in one night, flashes of lightening, powerful, while we ate dinner under and open-walled pavilion.

Highlights: For a three-night, four-day trip, we packed a lot in. But the biggest highlight for us was our traveling companions, three of the McCropder group. After almost a year of goodbye and transition, we were looking ahead. We laughed, more than we have in a long time. Should we admit this? It was fun. And, we sensed God's presence with us. My Bible reading prior to going fell in Ezra and Nehemiah, which was amazing timing. The parallels between Burundi and Israel at that point in her history are striking: small country, over-run by war, now with exiles returning to a destroyed infrastructure, rebuilding, facing opposition and doubt, balancing prayer and practicality, depending on God while also asking for financial help, repenting and reconciling and ready to be a blessing to the larger world. Our first night we met with some Burundian Christians who said the same thing, let this nation be rebuilt to bless others, even though we are small. The passion for tackling the problems of poverty, disease, tribalism, discrimination, witchcraft, hunger . . . was infectious. It is the Burundians who are leading, and they are asking for a few outsiders to come alongside and help, to train and teach and encourage until the 6 Americans are replaced by the 15 Burundians the Bishop prays for.

The story and the Author: When we touched down at the airport, we warned the McCropders that we did not have a very good track record of being met at airports (my first trip to Africa it took me days to find the people I was supposed to serve with; our entrance to Uganda we waited hours and thought we'd been forgotten). Sure enough there was no one waiting for us . . . but they soon arrived. Bishop Ellie's daughter La'Charite, and a retired missionary couple the Vibberts. And within the first hour, we realized the way God had prepared for us. It just so happens that the Vibberts' son was a friend of ours in Uganda, working in Bundibugyo, of all places. They embraced us like long-lost family. And it just so happens that Scott and Bishop Ellie attended the same seminary at the same time, Trinity in Chicago. God delights in these details that remind us that He is the author of this whole story. We don't know how this one will end. The next chapters will unfold this year as we present the potential for the new field to the WHM Board, and as the McCropders apply to join the mission. I don't know if we will join hands, but I hope we do. Either way, I'm sure that the McCropder's story, and Burundi's, and ours, will have suspense and drama and comedy and hope, and in the end, love will prevail.

Burundi Trip

Here's a report from the blog of our travel companions, with some great pictures!  http://mccropders.blogspot.com/2011/02/back-from-burundi.html

 I would like to believe that they have a better internet connection in their remote bush hospital than we do at ours . . . but our delay is also related to coming back to clinical responsibilities and kid stuff.  Yesterday Jack traveled with the junior high (7th and 8th grade) basketball team to a Nairobi-wide tournament and won first place!  He had a blast.  We all stayed here because RVA also sponsored a high school tournament for girls' football (soccer) and boys' basketball.  Julia's JV team entered against five other varsities.  They didn't win, but they did hold both of the top two teams to scoreless draws, and played very well.  The boys' basketball was the most exciting finish.  RVA won in overtime by a last-seconds layup from a very small 9th grader, Micah N.  They were playing a team of very TALL Kenyans who had crushed every other team in the tournament, so it was an unexpected victory and the crowd went wild.  

Thankful to mix a week of exploratory, open-up-the-dreams travel to a needy place; intensive care for severely ill and premature newborns and AIDS-ravaged adults; and memorable time baking in the equatorial sun cheering our kids on in sports.  The fact that one can do all three from this spot of earth is God's goodness to us.

If ever a place needed . . .

So much to tell, too much for 10:45 pm after traveling from Bujumbura to Nairobi, buying groceries, catching a ride back to Kijabe in time for another JV Girls' Football victory (with another corner kick goal by Julia, which we sadly missed by about two minutes as we arrived), cooking dinner with Bethany, and being called to casualty for a girl with meningitis and a boy with a punctured (tragically, pretty much destroyed) eye.  So I will just introduce the trip with this actual quote from a 1949 autobiographical history of missions in Burundi which we read while there (But They Right Hand by John Wesley Haley), and promise more tomorrow. . . . Kibuye is the town where we would like to place a medical educational team, right smack in the center of the country.  The Free Methodists established a hospital there in the 1940's.  Prior to the arrival of the first doctor, this letter was printed in a July 1938 newsletter called Nile-Congo Notes:

"Kibuye is a beautiful place.  The view is magnificient.  There are many people here.  Sister A. has started the dispensary work, and already has from two hundred fifty to three hundred patients every day, so you see I am going to have my hands full.  I have never seen such terrible sights in my life as I have seen here.  If ever a place needed a doctor, a nurse and a hospital, Kibuye does.  Will you who read plase join us in prayer that God may send for the necessary workers?  We also need a teacher.  'More things are wrought by prayer than this world dreams of.'"

Every word is still true today, 73 years later.  Missionaries came, built, blessed, went.  War swept through, in two major waves in the 1970's and 1990's.  Hundreds of thousands died.  A tentative peace was established, and the diaspora of educated Burundians returned with vision and hope for their country.  And now the door is open, the invitation given, for us to join in the effort of healing and rebuilding.  Doctors, nurses, hospitals, teachers . . let us heed the call of the generation past, and join in prayer that God would send them.

Heading to Burundi

In the happiness of a new computer as we returned to Africa, I am just remembering the sadness of the fact that my email lists for sending prayer updates did not transfer. One of these days I need to reconstruct. But not today. We are taking a deep inhale after the Banquet week and our small role in helping Caleb's class, on top of the ongoing energy-expenditure of adjusting to Kijabe. Last night was the big event, which meant that most of the afternoon I was helping with the final arrangements, then we were photographing the set, then the boys getting ready at the dorm, then the boys picking the girls up at their dorm and walking up. The theme, which can now be revealed (!) was a Venice Masquerade, with a clever skit, musical numbers, elegant table settings, a fountain, fancy food, masks and music. I found a place in the parent serving line, arranging plates and dishing up course after course, from about 8 to 11. The party went on 'til after midnight but once we served up dessert I headed home for a few hours of sleep before early Saturday rounds . . .and this morning Scott helped deconstruct, and Caleb is still up there cleaning. So we could all use a few hours to clean and cook and recover . .

. . Before tomorrow morning, when Scott and I head to Burundi. We're accompanying three young doctors-and-spouses on an exploratory trip to Africa Hope University, a decade-old Christian University with a new medical school and a vision for transforming the country of Burundi. This is a country in which several hundred thousand people were killed between 1993-2006 in an intractable civil war sparked by Hutu-Tutsi ethnic violence similar to Rwanda's. But in the last few years there has been a return to sanity and a beginning of healing. By grace, we were privileged to be approached by a group of young American missionary doctors currently working at Tenwek Hospital in Kenya through the excellent Samaritan's Purse Post-Residency Program, who were considering their long-term calling. We met up at the CMDA conference a year ago, and in the meantime they narrowed their calling down to Burundi, and we at WHM are in the process of enfolding them. They would form a team for teaching and discipling medical students, an ideal way to bring new physical and spiritual life to a suffering country. There are 0.3 physicians/10,000 population in Burundi (25-30 in USA, 2-3 in Africa generally).

Would you pray that we would experience together a sense of God's leading and calling? That we would bond as we travel? That God would watch over all our children as we're gone? (Classically, Julia has a temp of 101 as I write). That God's love would extend to many more people in Burundi as a result of this trip?

Thanks.

A link to HAU's recent newsletter: http://hopeafricauniversity.org/newsletters/november-2010

A link to the blog of the doctors we are traveling with: http://mccropders.blogspot.com/

Why We're Here, Again

Today, another reminder of why we're here. It's not one simple reason, but a collection. This hospital has become the destination of choice for people from a very closed, violent, unstable, and hostile country to the North. How ironic, that the people are coming TO the missionaries rather than the other way around. The word is out: here is a place where you are cared for. So they come, and many meet Jesus. This hospital is also a refuge for the marginal, and a respite for the hurting, from nearby and every corner of Kenya.

And besides learning a lot from the experienced and competent colleagues here, and serving the sick and poor, we're here because it's a good central place to communicate with all our teams, to discuss medical problems and research issues and chat on the phone. Uganda faces potentially contentious elections on Friday. Our team is bracing. We have enjoyed catching up with our Kenya and Sudan-based colleagues. And we leave on Sunday for a three-day trip to Burundi where we will be helping a potential new team research the possibilities for service.

But tonight I'm admitting that there is another, BIG "why we're here" dynamic, that is not so holy or noble but none-the-less true and dear to our hearts. We're here where we can live with our kids, and be part of their lives for a few more years. We left work early this afternoon and drove into Nairobi's western suburbs to the International School of Kenya. And we watched Jack's Junior High Basketball team win 41-22, cheering him on. For a kid who grew up in the "bush" and never played basketball until a few weeks ago, he's holding his own and learning the game. Scott and I actually only each saw half the game, switching back and forth, because Julia's Junior Varsity girls' football (soccer) team was also beating ISK 2 to 0. Julia is the power-foot on the team, takes all the corners and goal kicks. She is one of the most valuable and steady players, starts and plays the whole game, and loves it. So instead of hearing about all this on the phone, we get to attend the games, and thank the coaches, and share the excitement. And afterwards to cook dinner for all of them, and discuss their research papers or hear about what happened in their days.

Thankful to be here. The missing piece is Luke, and he's applying for a research fellowship to come for the summer. Praying.

patient notes

I am not patient, but here are some notes of why I should be.

Today Baby F went home, with a smiling mother. Not a tinge of yellow. Feeding well, and looking relatively normal, if you don't look too hard. No seizure medicines, no medicines at all. A grueling effort now recedes into the blur of hours long gone, and a delighted young woman, whose brush with bereavement came too close, holds a baby.

Today we got a final lab back on Baby A. He had been born in late November, and went home, at last, yesterday. I was only part of the latter half of his course, but it was enough to soberly acknowledge his escape. He was born as a premature speck to an HIV-positive mother. As if that weren't enough, he had dangerously immature lungs, and developed life-threatening meningitis, growing stool organisms from his brain linings. Not good. Three weeks of strong IV antibiotics and a small intracranial bleed later, he was still twitchy and volatile. One day it occurred to me from the dark recesses of memory that his spastic movements reminded me of some babies who reflux, whose acid-laden stomach contents boil back up into their esophagus. We tried some ulcer-calming type of medicines and positioning, and it did the trick. Slowly he emerged from his oxygen-dependence, and lost tubes, and gained flesh, and one day there he was, a little boy with a face and personality. When we discharged him, his mother (whose eventually fatal disease did not keep her from investing hour by hour in the survival of this son) simply said "I have no words to thank you, may God bless you." We prayed for A and his mom, and asked her to pray for us. So it was very sweet to get the news today that his HIV test was negative. He has escaped about four commonly fatal conditions already, and he's not even five pounds yet. That is mercy.

Those two departures made room for the next struggles. Baby H and Baby N, neighbors now in suffering. Baby H was born in a refugee camp for Somalians just inside the barren, distant border of northern Kenya. Only the problem was, where she should have had an open anus for passing stool, she had a dimple of intact skin. By the second or third day of life she was vomiting everything that could not pass through, and her mother got on a bus, alone, and took the two day trip to Kijabe, where she can't speak to any of us. We gesture a lot. This woman is a refugee mother-of-8, who just survived childbirth and a punishing journey, and sits now amongst strangers with a critically ill baby, which somehow amazes me. The surgeons saved the baby's life with a temporary colostomy. She has the most beautiful face. And her room-mate Baby N, faces a surgery tomorrow that she may or may not survive. She was born without skin or skull bone over most of the top of her head, only the linings which cover her brain. With a bandaged head she looks exotic, Nefrititi-ish, but beneath those wraps the dura membranes are darkening ominously. Her syndrome includes a whoppingly worrisome heart murmur and tiny malformed fingers and toes. But she is alert and otherwise lovely and feeding well, her mom's first baby. The surgeons tomorrow will try to stretch some scalp over her defect, and perhaps transfer grafts of flaps from other areas of her tiny body, bloody and technically challenging enough without the question of her heart's capacity.

This is Kijabe, a place that seems to draw in fragile, marginal, guarded-prognosis people. As Scott and I often say to each other, almost everyone we care for here would have been long dead in Bundibugyo. Instead, here, they are scooped up into the Kingdom, the mountain of the Lord that is populated by the scabby-scalped and jaundiced and spastic. Here they are treated with the honor of being important enough to warrant surgery and xrays and labs and effort. Here they encounter a few missionaries but mostly dedicated Kenyans, who are raising their own money for new projects, and providing their own administration, who are accessing the internet and pondering the possible. Bundibugyo in another fifty years? I hope so. Let us be patient.