There and back...again!

On short notice (just having returned from Uganda), I (Scott) was invited and agreed to attend the Planning Retreat of the South Sudan Team on the shores of Lake Victoria near Kampala.  One flight, four taxi rides, and an outboard motorboat ride later (next time I'll try to work in the camel), I found the South Sudan Team, hard at work - thinking through complicated questions of strategic planning for the coming year(s).  Again, I came to listen, observe, represent, and chime in on issues of policy and experience.    This is a team which living in a remote, harsh, and hot (!) place striving to serve a new nation with a fantastic diversity of skills.  Engineers dominate the team, but they are engineers adept at teaching the Bible, playing the guitar, or discussing ethics in addition to their obvious skills in making stuff work.  Others are investing their lives in health, education, and agriculture.  The challenges of living in South Sudan (Mundri) boggle the mind.  No grid electricity.  Only solar.  So, no air conditioning despite the consistent temps over 100 F.  Drinking water from a water bottle left on the kitchen table tastes like it has come out of the hot water tap.  It's not uncommon to hear any of five languages spoken in the market: Arabic, Moru, Swahili, English, or Somali.  Most of the men on the team study Arabic, while a few of the women study Moru.  

This team has been on the ground in Mundri for just under four years and what progress they've made.  They have a fruitful trusting relationship with their host denomination, the Episcopal Church of Sudan (ECS). They have tasteful housing, welcoming friends, vibrant church homes, appreciative partner schools (primary, secondary, theological), many new and refurbished water sources developed for the community…and a thriving volleyball league!   But they want more.  They want to develop public health interventions,  develop computer science centers, train more teachers, provide more medicine, raise up and sponsor students for professional training….it's exciting.  And it's very, very hard.

The South Sudan Team 

They need much more money.  For more housing (the Sudan Housing Fund) - currently in a puddle of red ink.  For infrastructure (like Internet service - the Sudan Operation Fund) - currently in a LAKE of red ink.  For a vehicle for the Bishop of the Mundri Diocese of the ECS…for computer training, sponsorship of students, short-term loans for small business start-ups, for drilling more water boreholes…there is so much which needs to be done….

And while one could feel despair at the enormity of the need, I feel thankful for this amazing team 

our dorm at the retreat

dinner with the team

There and back...

Three weeks ago, I (Scott) made a last-minute trip to Bundibugyo (Uganda) in order to attend a year-end review with the leadership of Christ School - Bundibugyo. 

There is something about the familiar which is so comforting, so relaxing.  Not that Entebbe is a particularly friendly airport, but I just breathe a sigh of relief after I touch down in Uganda.  I know the place, the rules, the prices, some language. It was once home and still feels that way.  After a brief one hour commercial flight from Nairobi to Entebbe,  I connect with friends from Mission Aviation Fellowship (MAF) and squeeze into the Cessna 206 with a pilot's yoke in my lap and scads of dials and meters in my face.  We end up spending nearly an hour and a half in flight because we need to divert around, above, and beneath various storms, but finally touch down on the soft earth of the Bundibugyo grass airstrip.  The door snaps open and the the hot, humid air fills the cabin.  

MAF Cessna 206 at Entebbe airport

Nyahuka from the air (CSB in foreground)

Bundibugyo airstrip and the gathering crowd

Guys from the team, beaming with smiles, welcome me.  Ahh, to know and be known.

Bundibugyo has changed.  From the air, the wide swath of destruction and construction which is the new tarmac road has reached Bundibugyo Town.  Only 12 more kilometers and the pavement will reach Nyahuka and WHM.  Not sure when exactly, but it will definitely be 2013.  While I had been warned that Nyahuka has changed - more people, more buildings, more development -  it seems that there is more that is the same than different.  The place is still lush green everywhere, the rutted dirt road is filled with motorbikes loaded with 2 and 3 passengers weaving around women pack-mules loaded with water and firewood.  As we reach the Mission, the greetings begin.  Faithful friends, despite the lack of foreknowledge of my trip, somehow discover me.  Students, neighbors, former workers, church members.  It's good.

Richard, Basime, and Kadima

Bamparana and Caleb

Mejili

Asta and Buligi

Isingoma, Michael, and Travis

But this is a working trip.  I come as the East AFrica Field Director, to listen and provide counsel about Christ School's future.  The school is in capable hands: Isingoma Edward, my colleague since 1993, is now Head Teacher.  He's ably assisted by Michael and Travis who represent "the founding body."  We've come a long way since 1998.  Our senior secondary boarding school is now ranked in the top 12% of the more than 1000 secondary schools in Uganda!   No small miracle for a school that is just entering it's second decade, a veritable adolescent in a district which just 20 years ago ranked dead last in the entire country.   I soaked in the stories of the dramatic and tense football season which extended all the way to the National Tournament - as well as the more mundane struggles of preparing meals for 350, of keeping water flowing in the taps, and of collapsing latrines (yuck!).  

CSB and new cell tower adjacent

CSB students and Isingoma

The purpose of this Christ School "Summit" is to make "the way forward" (as they like to say in Uganda).  We had a budget crisis this year.  Cocoa, the main cash crop of Bundibugyo, didn't come in and the price per kilo was low.  By the end of Term 2, we were swimming in red ink.  With the help of many friends of CSB, we weathered the storm.  But we want to avoid these situations which seem to happen almost every year - for one reason or another.  So…budget slashing was the overall theme of the meeting.  Tough, tough decisions…about enrollment, staffing, and curriculum.   We have a plan and we have committed it to God, trusting that He is the One who guides our steps.

My trip was short.  Three nights.  Sunday was full.  I preached at Christ School and Bundimulinga New Life Church.  Watched the Manchester United game with the Christ School staff.   And I saw Johah's wife who continues to amaze.  Her private primary school - Alpha - now has 19 teaching staff.  Unfortunately she faces the same struggles as we do at CSB.  Parents who don't pay school fees and a fixed payroll to meet.  Baby Jonah is almost five and apart from his mom and attending school in Kasese.   The life of a single mother who manages a school and four homes is taking its toll.   She needs prayer.

Melen

On Monday, I almost don't make it out because the pilot is hesitant to land on the soggy airstrip.  He does come, but too late for me to make my commercial flight from Entebbe to Nairobi.  I'm bumped to a later flight and finally stumble in the door at Kijabe just before midnight, thankful for traveling mercies.  A mercy that I have not died on that crazy trans-African highway, the A104. 

Cocoa drying in the market

Josh and his new ride

Bundi Team Meeting

the pizza place

these buildings will all be demolished by the new road

Bundimulinga New Life church

New gas pump in Nyahuka

Give Thanks

Today I am thankful for this verse

James 4:5:  BUT HE GIVES MORE GRACE.  No matter what is happening there is more grace.  Enough for the whole human race.

I am thankful for Scott returning from Uganda, energized by the great South Sudan team, meetings and prayer and hope.

I'm thankful for my kids making it to the end of exams, only one more half-day of school in the term.  Yeah!  Jack, Julia, and Acacia are ready to crash.  And Luke and Caleb already have, thankful for Scott's parents who are feeding them and providing beds, quiet, mountain bikes, and an ocean view in CA.  And my sister who is enfolding my mom into her celebration.  If we can't all be together, it is good to know that we're in groups together.

And thankful for our Paeds team, especially Amanda Hansen who is providing the venue for the Thanksgiving-Dinner-for-Forty-One that I've been trying to organize this month.  One more hour, the turkey is out of the oven, the stuffing is baking, the tables are set, and we're almost ready to roll.

 

 Thankful for patience, and Patience.  Two-month birthday on the left, 3-month on the right as this tiny preemie and her mom moved out of nursery onto the maternity floor for a few days to be sure that she was ready for discharge.  She had tripled her birthweight.  Her mom brought US cake, bought blankets for the next five preemies, and took OUR photos.  Celebrating this fruit of patient care.

And this little family miracle, much improved.  He and his mom nearly both died as she bled and he was premature, but they have emerged from their side-by-side ICU beds to the point of hope.

Tis the season of parties.

Thankful for the Kindergarten class who came to visit and sing carols for the hospitalized kids.

Thankful for friends.  This family faithfully sends us a Christmas package EVERY year, with a puzzle that we can spend hours of relaxing family time putting together.  It has become part of our yearly tradition, and the consistency of this package finding us here at Kijabe just made my day.

Thankful for this friend, who sent HIMSELF to Kijabe to work in pathology.  Ron G has been a friend since he and Scott went to med school together.  He was a groomsman in our wedding.  He is a supporter in the best sense of the all-around financial and prayerful and concerned friend.  He came to Kijabe for short term trips long before we did, and we're privileged to both be here together this year.

I'm thankful for our jobs here which involve intensive care of the sickest children, teaching the next generation of African physicians and clinical officers and nurses, research and data gathering, being stretched to work on difficult diagnoses (like possibly rabies this week!), sitting down to chat and encourage coworkers, learning from people much smarter than me, prayer around bedsides, and long term dreaming of excellence and mercy.

And that brings us back to grace, which is always MORE, more than the deaths and sadnesses and stresses and challenges, always available, always deeper than every trial.

Happy Thanksgiving to you too.

Not well, but . .

The world goes not well, but the Kingdom comes.  Today our staff at the hospital gathered and prayed for recent violence in Nairobi.  A grenade was thrown on a matatu killing ten people, and sparking riots between the predominantly ethnic S-li people of that neighborhood and other Kenyans and police (http://www.bbc.co.uk/news/world-africa-20389550 and http://abcnews.go.com/International/wireStory/riot-kenya-bus-bombing-kills-capital-17758455#.UKp6KuPZ-Kw).  Our WHM colleagues work in this neighborhood.  And many from there come out to Kijabe for care.  Then there was news that the M23 rebels of Eastern Congo are about to advance on Goma, the third wave of revolution to sweep from the border west since we've lived nearby (http://news.sky.com/story/1013240/dr-congo-rebel-advance-poses-real-threat).  There's also a simmering ebola outbreak in Luwero, relatively minor on the ebola-scale with two deaths and lots of panic (http://allafrica.com/stories/201211191399.html).  The evidence mounts for the world's not-well-ness.

But the Kingdom comes.  As you pray from now through Thanksgiving please pray for our teams in East Africa.  Scott flew to Uganda tonight to meet with the South Sudan team as they work through a planning retreat this week.  Pray they would seek God's face and follow His spirit as they draw alongside that Kingdom-coming activity in Mundri.  Pray they would be united in their teamwork, their diversity of gifts melding to bless the people of South Sudan.  Pray for Scott to have supernatural wisdom (as in not just his own, but insight from God) to offer as he participates. He'll fly home Thursday and then our Uganda and South Sudan teams will shift to a lovely restful hotel for a spiritual/physical refreshment retreat together.  Pray that they would encourage each other, and be blessed by those they've invited to lead them.  The Burundi team perseveres in language study, and we look forward to some friends landing at Kijabe next week after teaching at Hope Africa University.  The Kenya team is dealing with the terrorism mentioned above.  All can use your prayers.

It was the best of times . . .

. . as exam week approaches, goodbyes loom, anxiety mounts, there is a bit of worst-of-times seeping in.  And other aspects of community and school can be tough.  So here's a best-of-times tribute to RVA on a pre-Thanksgiving weekend.  Pinewood Derby, a masterpiece of logistics, and literally hundreds of races are run in an orchestrated computer-timed video-enhanced sports-announced production.  The entire school community seems to gather.  Cheering.  Conversations.  Some really good music by Mr. Peifer.  And really bad.  Excited kids, prizes, creative cars, occasional wrecks.  Julia and Savvy were doing a car together, which mostly meant Julia provided moral support and Savvy did the work, on a rhino car with a red mohawk.  Because both girls were in soccer tryouts Jack ended up spending a brotherly couple hours in the final touches and registration so he put his name on too.  So the three of them had a blast and made it to semifinals in their age group, but nowhere near fastest.  Just fun. It was a good time to eat and visit. And best of all Jane M with her mom Ann, our very own WHM-ites, won the women's category!  I love the empowerment that comes from a stadium of cheers when you're six (or any age).

Then today, Baptism Sunday, where eleven students gave testimonies, had favorite scriptures read, were baptized and prayed for.  In multiple languages, from many different countries, all desiring to identify personally with faith in Jesus.  Singing and guitars, outdoor amphitheater, overcast sky, families involved.  

But the best thing about both days was sort of the same.  A single mom here whose husband died in the course of missionary service.  Watching staff men who helped her young sons build and race their cars, and who mentored one of them as he made his profession of faith and baptism today.  What a great thing, to see solid men stepping into the gap where a comrade fell, showering love upon these boys.  Then add to that tonight's band and choir concert, four groups, about two dozen pieces all related to Christmas, all wrested from kids who have learned to play and sing and cooperate in the last few months.  And essentially that is RVA, at its best, a community of dedicated people pouring attention and skill and concern and challenge and love out onto other peoples' kids.  Because being a missionary kid, or any kid, carries so many losses, from the tragedy of a father killed to the subtlety of not quite fitting in to a new culture, and everything in between.  So thankful in particular that our very own Bethany F has been here to counsel and encourage kids this term.  It's a good thing for a place like this.

So to dorm parents, teachers, choir directors, counselors, administrators, cooks, coaches, librarians, secretaries, launderers, nurses, maintenance experts, and all the other diversely gifted people who make up a school like this, thanks.  Happy Thanksgiving.

Victories, mostly

Not all of the last week has been alienating (see below).  In fact there have been some true celebrations.

First and foremost, Scott's Birthday.  Another year, another dozen roles and abilities.  His capacity for being diversely gifted and wise in doctoring, fixing, mentoring, scoring goals, cooking, creating (won the WHM Christmas photo contest too!), building, writing, organizing, fixing again, saving, listening, deciding . . . is exceeded only by his capacity for putting up with me and Africa and the whole mess of life.

Luke's Football Club of Yale University went to finals in the Ivy League tournament, won their conference, and placed respectably in regionals.  He had a great season of friendship and football, the essential outlet for Yale survival.  Caleb's Thunderbird Squadron 27 intramural team also went to finals (40 squadrons) at the US Air Force Academy.  Another essential outlet for survival.  Jack's RVA Varsity Football team also went to finals, their first defeat in a great season. So all three boys enjoyed solid season finishes in the #2 position, all as wings mostly, fast, running, defense, shots, and camaraderie.  And in the family theme, Acacia's JV basketball also finished 2nd, losing by the narrowest of margins in the finals.  And Julia's tennis team made it to semi-finals, so I guess they were 3rd or 4th in the league.  All these sports have been great fun to watch and cheer (from afar for Luke and Caleb, but field/courtside for the younger ones).  I'm grateful to coaches.  Grateful for exercise and confidence and opportunity.  And on pins and needles as the RVA three go through tryouts for the next season, I believe/help my unbelief, trying not to be the mother who asks for right-hand-seats-glory for her kids (Matt 20:21) (others seem to pray for this and then their kid scores the goal), but to trust that the teams will prove to be blessings to my own and to others.  But I can't help hoping the kid who got cut last year won't have that happen again.  So if you have more faith than I, pray for that.

And lastly, on the theme of birthdays, parenting, and victories, here is baby L on the day she was discharged, snuggling up with a very happy Mom.  The next ICU-save baby, baby F, also made it off the ventilator and back down to the nursery this week.  Thankful for life being stronger than death in these two.

Add to all that an unexpected gift of a visit from Karen, walks with friends including neighbor Sheri who had been traveling and is back, a movie with Bethany, days of sunshine and dry clothes on the line, cream cheese frosting as a rare grocery bounty in town, huevos rancheros at Java house after the alien debacle, prayer with fellow moms, and an all-hospital all-out party to celebrate the new Maternal and Child Health (now called Family Health) clinic, the new about-to-be-turned-on CT scanner, the new palliative care building, and the cornerstone-laying for the new BKKH paediatric wing . . . well it has been a celebratory week.

Thankful for the moments that give a glimpse of belonging and thriving, even if not all is victorious in this fallen world.

Rule-weary, and Confessions of Lovelessness

"If every human being had the capacity to do the right thing every minute of every day, humankind would have no need of laws.

But since all of us have the capacity for both hatred and love, we are compelled to make rules that provide our best judgment for how to live together in peace and justice. Laws alone cannot ensure our well-being, however. The stories of our very best human selves are the stories of our love for one another — the stories where laws and social norms are trumped by hearts that love and people who follow their hearts and act on that love.

Consider now how love can help us be our best selves."

This quote comes from http://www.d365.org, an on-line devotion we read as a family at breakfast in the mornings.  And I've gone back to read it several times recently.  It's been one of those rule-weary cross-cultural stretches.  A boarding school is a rule factory.  A missionary station is a diverse community, and every passing month seems to generate more rules or protocols or meetings or structures.  A foreign country has its own laws and makes it clear that we don't always fit in.  So as a missionary/doctor/mom/class sponsor/community member in Africa, there are a multitude of overlapping cultural lines that one must tread carefully.   In the last couple weeks I've showed up twice to events to which I thought I was included, only to be excluded with unintentional harshness.  And as a final straw, Kenya has declined for the time being to register us as aliens, having lost our paperwork.  The only thing more alienating than being an alien is being an alien who can't even have an alien registration card.  

So I admit, I've felt a little sorry for myself after some of these interactions, and tempted to throw in the proverbial towel.  But that very thought points out the real issue. " Towel" may be a boxing metaphor, but it is also a Gospel symbol of community.  Jesus washed feet and wiped them and called His followers to be servants not lords.  My capacity for hatred and judgement and exclusion is greater than my capacity for washing grime and tenderly wiping.  I'd like to imagine that without so many rules I'd be a sensitive neighbor and kind doctor and generous friend and sacrificing parent.  However the truth is that the same selfishness the laws are designed to protect our community from fills my own heart too.  So even as I sigh clinging (literally at one point this week) to the outside of the fence, instead of wishing it away I need to learn to live in the bounds of this community, extending grace.  

I'd like to trump rules with love.  Which does not happen by pointing out the absurdity of the rules, but by acting consistently in love, day in day out, until those who are trying to protect themselves and their community with ever-more-detailed laws relax in the fear-casting surety of love.  Which I suppose won't happen until the all-things-new of eternity.  When we finally won't be aliens any more.

Paeds Team

This is the great group of people with whom I work, at our monthly meeting.  So thankful for the wisdom and dedication of Mardi, Lillian, Mary, Erika, Ima, Bob, SarahG, Rick, and especially (not pictured due to hold-up in immigration this morning) SarahM!

Addicted to Resurrection

Jesus said, I am making all things new.

The privilege of working right down in the nitty gritty of that is pretty astonishing. The last couple of weeks I've seen it up close. Baby L, whom I've written about before, is now able to rest in her mother's arms and feed. Almost anyplace within a thousand miles she'd been born would have meant a lifespan of about one minute for her, but now she's edging towards the possibility of discharge. Her mother thanks you for your prayers, and said we could show her smile.

This week it was baby H. His mother arrived as a transfer from another hospital with a hemoglobin of 5 (that's almost too low to survive) and a blood pressure of 60/24 (that's also just a shade from demise), bleeding profusely, her life and her baby's draining out of a placenta in the wrong position. Our OB team rushed her to the theatre and our Paeds team received the baby whose heart still beat, but he was limp and blue. I found him being resuscitated, and spent the next two days and one night basically within a few yards of his cot. There is something very intimate about intubating a baby's trachea, putting an intravenous line into the umbilical vein, listening, watching, examining, calculating drips and fluids and meds, fiddling with our ancient ventilators, watching the monitors. And texting Dr. Erika our 6-month short-term neonatologist, about thirty times, because this baby was as sick as they come and way beyond my expertise. With great advice from Erika though and every medical therapy we could muster he's dramatically improved. Not out of the woods, or even out of the ICU, but not dead either and definitely trending towards recovery.

I am thankful to be a paediatrician. But that night I got a little taste of Family Medicine as I pulled for not just one ICU bed but two, to save the mother as well as the baby. As I struggled with his poor lungs and low blood pressure, I kept looking at his mom's numbers too. She's out of the ICU now and well on the way to being healed. She and her husband are small farmers with no margin for disaster. We will end up once again paying for a good portion of Baby H's care from our emergency Needy Children's Fund. Both babies were vigorous in their own ways, fighters, with little eyes that flutter open and just LOOK at you as you're trying to help them, faces that grimace in a soundless cry around the endotracheal tube, legs that kick. It's hard NOT to keep struggling for a baby that looks at you like that.

In Mel Gibson's movie about Jesus' passion, the all-things-new quote is placed on the walk to the cross. Which is an important juxtaposition, one that I tend to gloss over. Resurrection comes at a cost. For Jesus, the real maker of all things new, his life. For us, his apprentices, mere inconveniences like a bit of lost sleep, or discouragement, or mistakes, or weariness. Perhaps that is necessary, because this resurrecting business could become addictive.

Counting more thanks

THANKS for the tremendous response to the post about the needs of babies at Kijabe hospital.  Over four thousand dollars were sent by various people, and another several hundred is in the works from a family that decided to make this their Christmas presents to each other.  Besides the two babies who I had asked for help for, I expect this generosity to touch the lives of at least twenty more!

The pictures are of Baby L.  The top one is from one of her first few days of life when she was intubated on a ventilator (breathing tube and life support), had chest tubes draining fluid from both lungs.  She was delivered at Kijabe after a prenatal ultrasound showed a rare and often fatal condition called Hydrops Fetalis.  Over the last three weeks we almost lost her many times. The lower picture is from her 3-week birthday on Friday, when she was breathing on her own with a little oxygen, and being fed.  She still may not make it, but the fact she's still alive is nothing short of miraculous.  She's a first and only baby for her dedicated parents, and they have also swung between hope and despair.  I expect they will work hard to pay most of their bill, but three weeks of intensive care adds up, and we will be happy to be able to help them a bit.

I put Baby L up here to remind all of us that where our treasure is, there our hearts will be also.  I know the people who have partnered with Kijabe Hospital to help children are now investing prayer in their recovery.  I certainly care more about Baby L than many random Kenyan babies because I've spent hours and days and nights struggling for her survival.  Please do pray for children like her to be rescued and to recover fully, for parents to have patience and perseverance, for nurses to work with stamina and insight, for our trainees to learn as they serve, for our consultants to be alert to the correct diagnoses and to carefully direct the team's care.

For now we will close the appeal for the Needy Children's Fund, and let you know when the money you've given has been fully used.

In the meantime if others are thinking about holidays and end-of-year blessings, we have plenty of other great options. One would be the Dr. Jonah Memorial Leadership Fund, the WHM-based fund in honor of the late Dr. Jonah who laid his life down for the gospel during ebola.  We have five young men in medical school, one doing an MPH, and one recent CSB grad (friend and classmate of Caleb) applying as the direct fruit of Dr. Jonah's buried seed.  As each year goes by the tuition costs in Uganda increase.  But we believe these young people are the core of the Kingdom coming in Bundibugyo.  Each is committed to return and work there.  This is much easier since the fund is administered through World Harvest.  Just click http://www.whm.org/project/details?ID=11129  for information on donating.

As we count our blessings in November, we are very thankful for generous friends who join with us in very concrete demonstrations of the love of Jesus to those who are aching for a sign of redemption.