Looking for Mercy

Walking out of church this morning, the sun went behind a heavy cover of clouds.  Our little rented house requires a ten minute walk, dusty, steep, uneven roads strewn with rocks.  Mid-day glare and heat can be intense, so the cloud cover was a relief.  Which reminded me that the same clouds which last Sunday obscured our Easter Sunrise can also be a mercy.  A protection.  If everything we are and everything we do was exposed to the burning holiness of God's glory, we'd be crisps.

It's been a long week.  

I suppose I don't want to get used to deaths, but some days are harder than others, sometimes the heart more fragile.  Friday morning we biked to the hospital as usual.  I had known in the evening that two babies in the Newborn Unit had worrisome lab results, and consulted about them, so before the teaching conference at 8 I thought I'd just take a peek to know what awaited us.  They were side by side under the eerie blue lights that treat jaundice.  Baby H, the first, looked up at me wailing.  She was vigorous, and while still battling infection, looked better than she had the day before when I was doing a lumbar puncture and noting deepening jaundice and lethargy.  Baby F lay quietly in the next bassinet, with a light blanket over her, IV dripping.  The night nurses were preparing to sign over to the day nurses, so all 4 (2 per shift) were coming into the room, and I began to remind them that phototherapy is not very effective if the baby is covered.  As I unwrapped F, I thought, this one is so still, is she alive?  Turns out the answer was, no.  I tried to resuscitate her for the next 15-20 minutes, pretty much alone, giving breaths with a bag, doing chest compressions.  A nurse helped me with adrenaline and with tubing to connect the bag to oxygen, but otherwise they continued their sign-over.  The baby had probably been dead for fifteen minutes or half an hour by the time I found her, she wasn't cold and stiff but she had no response to my efforts.  Most likely an infection that our antibiotics could not reach.  An hour or two later, after seeing the dozen sickest ward patients in our acute room, I was back to round with the team.  We reviewed baby H, and now that baby F had died, the next patient in the line was also a critically ill newborn who had presented the day before with severe breathing difficulties, also due to an infection we thought.  He was on CPAP, our highest level of oxygen therapy, but the hospital was running out so only two concentrators were supplying all of the babies.  The intern started to present this one, and I noticed he was grey and not breathing.  Was he dead too?  There was a faint, low heart rate still, less than 20 I'd say, but with bagging oxygen into his lungs that started to come up.  His IV was out, we noticed when trying to give drugs, and checked the notes.  Last fluid was midnight, now it was mid-morning.  It could have been a low blood sugar, or progression of infection, or the marginal oxygen supply, but though we worked for an hour and had him back most of that time, he eventually died too.  Two babies in two hours.  And with both, the sense of not only fighting the disease, but also fighting the inertia of a system overwhelmed by numbers and unconvinced that intervention matters.

There were 30-40 other babies besides those two.  One was a twin I had found dying two weeks ago, just like the stories above, but she is almost ready to go home.  There are several little 2-pound preemies, and many exposed to AIDS, and a massive 5-kg (11 pound) baby whose mother delivered naturally, and several sets of twins who are on the small side, and a few born at home who come in with infected cords, and some who convulse after difficult deliveries, and two with mentally retarded mothers who have to be helped to feed their infants.  On the ward there are 50-60 kids, many being rescued from malnutrition, AIDS, TB, respiratory viruses, asthma, dehydration from bad gastrointestinal infections, pneumonias galore, kids with CP, with kidney disease, with burns, with rashes.  Two dying out of a hundred in a morning, well, one could say that's a 98% success.  But it doesn't feel that way.

When I am saddened by loss, and frustrated with the system, I want to blame someone or something.  But the same glory of God that would fry those bacteria and zap the malfunctioning equipment and sear the passive-aggressive attitudes would also singe my pride and self-righteousness.  We need the clouded mercy of God's delay in setting everything right.  That cloud gives us time to change, to embrace goodness by choice and not by being overwhelmed by the power of the glory.

This job is relentlessly cross-cultural, fraught with uncertainty, daily pushing limits.  But one day I believe we'll realize just how great the Mercy has been that has surrounded us.

Easter, through the clouds

This, indeed, was our Easter Sunrise Service.  Huddled believers, the chill of a strong wind carrying our voices into the rocky horizon hung low with thick, grey clouds.  Our clocks told us the earth had turned, the sun was shedding light in our direction.  But we could not see even a hint of its color or warmth.  As we listened to Belle read the Gospel, and tried to sound peppily positive about forcing all these people out of bed before 6 am, wishing for a spectacular break-through of the rising sun, it occurred to me that the Easter morning we got was more appropriate.  Instead of irrefutable glory, we got the obscurity of clouds.  The muted veil that calls for faith.  

In the original story, hardly anyone recognized the risen Jesus.  There was confusion about grave robbers, angels, soldiers, a gardener.  Nothing that week seemed to go as expected, and the moment of triumph upon which history hinged was mostly experienced as grief and frustration by those who were present.

Which pretty much sums up 2017 in East and Central Africa.  Here we are, barely audible in our small songs, with a view of only a few meters.  We have countries where governments are imploding, corruption and suspicion permeate our work.  There is war, and rumor of war, and abuse and hunger and broken families.  There are babies born too early, too weak, too poor.  There is tribalism and jealousy and longing.  There is traffic and malaria and power outages and drought.  There are petty unhappinesses with each other, or injuries, sicknesses, financial pressures, misunderstandings, that drive us apart.  There is loneliness.  Yes, we are in the cloud, and we can't see the sunrise.

But behind the clouds, we trust the Son does rise, with healing in his wings.  Like 2000-ish years ago, Jesus still appears to small groups, friends walking, at meals.  Still with gentle questions and reassuring presence.  Still just quietly enough to be ignored at will, but found if sought.  Still in relishing community, in soaking up nature, in sharing nourishment, in collaborative work, in circling for prayer.

Easter held all of that for us.  We joined our old friends on the Kijabe team on retreat in the wilderness, to reflect on the season and pray for each other and worship God.  Much of the weekend was flooded with light and peace, the fellowship of deep thinkers and ready laughers.

There were sunsets, and hikes, and strenuous bike rides, and a delicious menu planned by our talented chef and team leader Ginny. There were wide skies, and blue horizons.

And there were clouds, which in the Bible both symbolize the need for faith, and the tangible presence of God's glory.  It's easier to long for sun, but the palpable presence of God has often been seen and felt in the cloud.

From the wilderness we returned to our Naivasha work, and hosting a visiting artist/former missionary kid guest, and touching base with our team leaders.  It's been a cloudy week where one has to take it on faith that God is at work.  We scrambled yesterday to do our first-ever exchange transfusion in Naivasha on a very very sick baby, who died at the end (it's a procedure to lower jaundice in its most severe form, which involves slowly removing and replacing the entire blood volume twice).  We're in a battle, and we often seem to lose.

Lose, but not leave.  I'll end this with some of the trees we saw hiking this weekend.  These are scrappy trees, the kind that have to put roots into rock, that have to hang off cliffs, that have to reach to the sky with dry thin branches.  Pray for our friends, for us, to hold on like this.  To accept the cloud above and around us, because we are anchored into the Rock below us.

This last one must be pretty much how our Ranger Student son feels.  Almost over the edge, but still grasping for a hold.  Two more nights of patrols, then the long march back to camp, and on Sunday the decision:  pass or repeat or be dropped.  Pray for him please!

A glimpse against gravity

This profound piece of art grabbed our hearts when we visited San Francisco (Scott's parents) in January.  The artist took actual pieces of an African-American Baptist church that had been destroyed by arson, and depicted them rising in a resurrection.  The charcoaled scraps of wood are themselves extremely material, tangible, and hopelessly damaged.  Yet the installation gives them both an austere beauty earned by their destruction, and an earth-defying anti-gravity upward-rising trajectory.  The actual effects of evil, the aftermath of hate, are being transformed before our eyes as they resurrect in a glimpse of a Kingdom-among-us dimension.

Today, on Good Friday, I find myself thinking about this exhibit.  Evil at our fingertips, and in our hearts, every day.  Yesterday on rounds as we progressed around the Newborn Unit, starting with our 630-gram 25-week premature boy who almost certainly cannot survive and then moving on from sickest to most stable, we came to a moderately-sized preemie who was under the blue lights for jaundice.  The intern started presenting her data as I turned off the blue, to evaluate her jaundice, and I noticed her color was rather sallow.  So I started to examine her, only to realize she was dead.  We did CPR for a short time, but this baby was stiff, with the wide pupils of a brain long gone.  It seems in the morning the nurses had noticed her abdomen very distended, and stopped her feeds, but no one on our team knew, and by the time we realized we should have changed her antibiotics when the jaundice started, it was too late.  In February I had 27 deaths in 28 days. Death is horrible, and ugly, and depressing.  Poverty plagues this area.  HIV/AIDS affects numerous children on our service.  The wages and living conditions of women who work long hours on the flower farms are far from just.  The passive-aggressive attitudes of some of the health workers drag us down.  Scott's dad's brain injuries grieve us. My own compulsion to correct, fight, criticize, form an opinion rather than listen with compassion, gets me in trouble.  I feel sorry for ourselves too quickly.  In short, this world is a mess, evil burning through our attempts at worship in a thousand ways less obvious than a burned church.

It is only with a eyes-open view of reality that Good Friday comes into focus.  The suffering servant, Isaiah says, had no form, comeliness, or beauty that we should be attracted to him.  He was a man of sorrows, acquainted with all the depths of grief, hate, destruction that humans devise.  Like the church above, he was attacked and violently destroyed.

But in the moment of that dissolution, a profound shift takes place in the universe.  The Friday of the cross becomes good, because an actual power goes out like a drop of blood and water whose ripple affects the entire space-time continuum in all directions.  This year, the truth has jumped out from the page, that the cross isn't just a legal execution that tallies and account paid, so that we are somehow judged free in spite of all the mess we are actually in.  Rather the cross is the fulcrum of a reversal of all that is wrong, an actual cleansing, and actual change in us and in the world.  The pieces of the burned church rise up to become a cathedral of God.

Passports, barriers, and structural racism

The passport on the left has been with me for ten years.  While waiting in an interminable line to pick up the new passport today in Nairobi, I flipped through the pages and counted 229 stamps.  That's a lot of visas, a lot of borders, a stamp as you leave, a stamp as you enter, a scowling perusal of my pages or a friendly curiosity.  There's the sea-shell shaped Seychelles stamp from our 25th anniversary, the green one from the Republic of Ireland, and many, many simple exits and entries from Kenya and Uganda.  

We are world citizens, but at this point in history we all still need a specific place to be from.  Someday perhaps we won't, when the Kingdom comes and there is neither Jew nor Greek.  When the saving all-things-new resurrection power that poured out of the wounded side of Jesus flows into the river whose waters produce trees that heal the nations.  But for now, there are forms, lines, taxes, rules.  

So I'm thankful for my USA passport and the way it allows me to move over the barriers that humans have demarcated to pull in close with those that are like, and keep out those that are not.  Having now lived almost as much of my life as an alien and stranger than not, our USA identity becomes complicated.  We claim it even while keeping a foot over the line outside of it.  We live in the advantages of American security and wealth that follows us even to sketchy distant lands.  But we also look back with incredulous puzzling concern at much that transpires these days.  

This week there were missiles descending in Syria, a show of naval presence in North Korea, the new Supreme Court Justice Gorsuch sworn in, a meeting with China, another school shooting (which continues to help make American schools more deadly than life in Kenya), a governor resigning, and our president's spokesman forgetting about the holocaust as he tried to justify the missile attack by making Assad look worse than Hitler, which was an embarrassing gaffe.  But none of this got a fraction of the attention that United Airlines received when security personnel forcibly removed a passenger for no reason other than they decided to revoke his ticket to make room for their own employees.  Thanks to cell phone video, the entire incident has been viewed over and over.  

It looks to me like the way many people of color have been treated by the police for decades, centuries.  But this time, the man under attack was someone middle and upper class viewers uncomfortably identified with.  A doctor. A paying passenger.  A person unwilling to have his plans altered.  Viewers collectively gasped to realize, "that could be me."  Poor thinking by United, resorting to force instead of raising the stakes until someone bit on the refund.  But maybe this will have a positive effect, shaking up the all-lives complacency of the majority to imagine themselves dragged by security officers with the same disregard that people of color experience day in day out.

Saw this study in Lancet this week:

 Structural racism, the very unequal experience that people have based on their skin color as they navigate life, shows up in disparate health outcomes.  Babies who are black die at twice the rate of babies who are white.

So I feel the crisp promise of a new passport, ready for another decade of border crossing into places where God calls us.  And the appreciation for the government which stands behind us.  But this week as others, we also long to see America embrace her ethos of welcome to all, and long for the day when passports are a distant memory.

First, do no harm

While our goal is to be a good and faithful servant (see previous post), not necessarily to be recognized for success, as medical missionaries we also ascribe to the ethical injunction of primum non nocere. First, do no harm.  Which is more complicated than it sounds when you are a bit of an outside-the-system whirlwind with your degrees, your laptops, and your bottles of hand sanitizer (to paraphrase one of the best movies of all time, Blood Diamond).

Whether we are living in a rural village trying to come alongside grandmothers caring for orphaned infants, or standing in front of a classroom of pastors, or pushing a mother into the operating theatre for a cesarean section, we believe that being a faithful servant means using all we have been given to the best of our ability in the service of our fellow humans.  For the world's good and God's glory, as our Serge tag-line goes, means we have to pay attention to what is actually good for the world.

Over the last few months, a good number of our Serge teams have been attempting to so just that.  While we were in Burundi, the Kibuye docs were preparing two poster presentations for a scientific conference in the capital, sharing their experience on improving conditions for neonatal survival and using recorded teaching to boost medical student performance.  At Kijabe, our team has laboriously collected data from blood, urine, and spinal fluid cultures to determine which antibiotics will be most effective.  In Chogoria, the team is working with local pharmacies on a research project to improve prescribing practices.  Today I've been putting together a poster for the Kenya Paediatric Association's annual scientific meeting, evaluating three data sources public hospitals could use to measure neonatal outcomes (we aren't in Kansas, I mean Kijabe, anymore where consultants enter every patient into databases).

And while I was working on that, we got the email that an article was just published (link here) by one of our former missionaries who is still processing data from the nutrition program in Bundibugyo.  It shows that our BBB program actually does improve the diet of children even AFTER they complete the program, as their caregivers learn to feed a greater variety of foods, and more often.

People of faith should be leading the way in a solid insistence that we give our very best for those we serve.  Jesus gave his very life; let us follow in those steps.

Well Done Thou Faithful

On Sunday we had the joy of attending a baby dedication at Mamlaka Hill Chapel, a vibrant center-of-Nairobi church where many students and young professionals find fellowship.  It's the kind of place where the worship rocks with passion, and you leave feeling hopeful that with a remnant of these hundreds of God-seeking Kenyans, the country can't totally disintegrate.  The worship leader made a comment that has stuck with me, as we long to hear the words the master speaks to his servants in the parable of the talents in Matthew 25, "Well done thou good and faithful servant".  She pointed out: notice he does not say "successful" but rather "faithful".  Depending on how one views the purposes of God, the focus on faithful rather than successful can come as a merciful relief, or a disappointing frustration as power and prosperity slip through our fingers.

This billboard promises "Power and Prosperity" at another church

On the other hand, after 5 "unsuccessful" pregnancies, a mom's faithful willingness to persevere looks beautiful.

In this week of remembering the final days of Jesus' life leading to the cross, we watch him walking with determination but a growing awareness of the horror and cost.  Meanwhile his followers, like us, were still stuck on success, who would be greatest in a Kingdom marked by triumph.  They over-estimated their own courage and capability, while Jesus washed their feet and prayed for their resilience in the hours of fear and loss that were looming.

Perhaps successful and faithful present a false dichotomy, which hinges on the definition of success.  Luke records Jesus' response to their dispute:  leadership in God's kingdom is not a matter of title, privilege, honor or power.  The invitation to feast in the Kingdom is conferred and not earned, and the response should be to serve our fellow feasters.  We enter and thrive, not by maiming the opposition with a well-placed sword to the ear, not by forcing our position to be acknowledged, but by walking the cross-path of fellowship in his sufferings.

This mom found me to show me her preemie, back for a check-up.  I would call that a success, I hope Jesus calls it faithful.

I confess I'd rather have a trusty sword or a seat at the high table most days.  Walking around in a towel dealing with filthy feet feels slow, tedious, and even unfair if I confess the truth.  But the word "faithful" gives me perspective.  A faithful servant uses the talents well.  For some that might mean a very visible position of responsibility; for others that might mean decades of hidden small kindnesses that die like seeds before any fruit is seen.  I think we as missionaries really need to grapple with this.  A faithful servant does not simply tread water to maintain the status quo by burying gifts beneath a pious insistence on not rocking the boat.  That can be fear more than humility.  Nor does a faithful servant blaze into the room and reorganize the party to his advantage.  But faithful can mean a dramatic healing, a rousing speech to a crowd, a threatening challenge to evil in authority.  Jesus' path to the apparent "failure" death of a criminal involved all of those points of "success".  Faithful can mean preemies surviving, the hungry fed, the Gospel preached widely, students passing exams or winning games, a job well done.

Faithful can also mean slogging up mountains and through swamps.  For those not on our email list, the good news this weekend was that our Ranger Student passed the second phase and is on to the third.  And our Medical Student persevered through his Step 2 Board Exam then used his free days to encourage his siblings.  I wish all four of them more worldly success than is probably healthy, but when push comes to shove, I am thankful that they are faithful.

The three, cheering on the fourth in their hearts and prayers.

Faithful is a hard metric.  We can't measure our own hearts, let alone anyone else's.  But it is a good goal.  Pray for us to be faithful, and leave the success in God's hands.

A Tuesday Slice of Life

If you see this on Tuesday, pray for that incredibly good-looking guy on the far right who is now sitting in a testing center in Richmond VA slogging through seven hours of clinical questions that will label him with a number that will largely impact his next 5-7 years of training.  And the also incredible guy in the center is slogging through week 10 of sleep deprivation, calorie restriction, constant marching, and hostility, with hopes that on Friday he'll be told he can go on to the next 3 weeks of the same, only this time in waist-deep swamp water in Florida.  The other two are writing papers and taking tests and planning summers and growing as humans with friends and sports and fellowship.  Miss them all.

Meanwhile here in Kenya, the world is slightly more aligned as Scott returned from his time helping his mom and dad in California, and I hosted our delightful Bundibugyo Team Leaders.  Just over 4 years ago we were part of the plot with Josh to get Anna out to Naivasha for a surprise:  he was proposing. So this trip we re-visited Crescent Island and Elsamere and reminisced.  It is a treat to walk with people over time, to be part of the important moments in life.  Michael Masso happened to also be taking students from South Sudan to see the animals.  Our stories are like that--longterm friendships, marriages, new life, rescues, opportunities, and also war, displacement, losses, sadness.  All mixed together in the complicated pattern that only God can redeem.

But sometimes there's a giraffe right over your shoulder, and the sun is shining, and the wind is blowing, and you're with people who fill your heart.

And other times, you're wading through a ward where a ten year old with newly diagnosed AIDS and probable TB is crying because of chest pain and looking pale and dyspneic, or one of the beds in the acute room of the sickest patients has not two but THREE babies with three moms jostling for space, or newborns are convulsing with meningitis.  And you come back to squeeze in time on the computer to write up policies, edit MOU's, plan travel, respond to new recruits, work on a lecture for Thursday, write letters, respond to questions about student sponsorships, or sort through Kenyan taxes.

Life is rich with meaning, and challenging with the pull of so many directions.  Listening and longing for Jesus to be enough for all of the above, and more.

In Honor of National Book Week

One of the most fun facebook posts of the last week was in honor of National Book Week:  copy the 5th sentence of the 56th page of whatever book was close to hand.  My comment feed ran from snatches of a narrative (a foot on the stair . . or the bad-news look on the teacher's face), to practical advice (hold two short assemblies each week), to memoir (that is as close as I ever got to earthly treasure), to the poetic (whose homeless feet have pressed our path of pain).  The final comment: "It is not, by and large, an endeavor for those who relish a quiet life".  Something about lifting all those lines from their context and stringing them together from around the world leant each a profound weight of truth.  Their diversity quickly showed the power of literature.  Within reach, a plethora of portals to realms beyond imagining.  That's truly amazing.

I'm not sure I've ever heard of National Book Week, though a quick google indicates it is celebrated in South Africa.  World Book Day was either March 2 or is coming up on April 23.  Whoever decides these things, it doesn't really matter, as long as they serve to stoke a thirst for reading.

So, here are a few of the books that I've been reading recently, mostly via the Upshur County Public Library's kindle lending program.  I can borrow a title electronically in Kenya from our West Virginia system.  That is something to be thankful for.

The author frames a series of journal entries and letters that date back to the 1880's within a current narrative of a museum curator to tell the story of American exploration in the territory of Alaska. Basically a very difficult journey into the unknown.  Good writing, strong character development, a variety of narrative voices, a poignant love story, touches of magical realism which lend color and mystery, and an attempt to give a voice to the indigenous American Indian population. There is a sub-story about photography in which the character tries to capture light, in a context that otherwise has much darkness. I didn't want this book to end, and I've thought about it often since finishing it.  Recommended highly.

Suspenseful, gripping, you care about the protagonist.  This is a journey through the terrible realities of our own country 200 years ago.  The author reveals much of the evil that drove slavery.  Worth reading as an American who cares about justice and knows that the bloody stain of slavery still seeps into most aspects of modern culture.  Like the tracks on the cover, the plot tents towards dead ends and sharp curves.  Recommended but wishing for more closure or cohesion.

This novel presents itself as a series of historical documents about a murder trial in a rural Scottish community in the 1860's.  Like the other two books above, the texture of details gives depth to the story and valuable images of a time long gone.  One learns of the massive inequality and injustice inherent in the "crofter" system of labor, and painfully watches the protagonist beaten down by a relentlessly evil overseer.  Reading about poverty in an articulate voice is always worthwhile.  And the intersection of mental illness, social distress, and criminal behaviour seems relevant. But this one is pretty much empty of redemption.

"Dark and redemptive" is my preferred genre in books and movies.  The three books above are ranked best to decent.  All relate to our family in some way:  Caleb will be posted to Alaska later this year, and my ancestry is a mix of African slave and Scotch-Irish immigrant, so the latter two give context to the situations from whence our ancestors arose.  

One more that has no actual personal connection but is also from a subset of that dark and redemptive genre, the apocalyptic tale, that I also enjoyed in the last few months.  How does art help us survive, what is the role of culture when everything falls apart?  Good read.

Books currently open:

The Arensen family have not only done much good on this continent, but possess the articulate gift of telling stories about it.  About half way through; lots of stories from the days when kids rode a steam boat to the rail road to go to RVA, or when you could drive out of Juba and go hunting for meat. 

Each poem is a sonnet related to a saying of Jesus, so I've enjoyed selecting some readings to go with the Lenten devotions.  Also this is a year to remember the poetry of life, so this is one way I'm trying to do that.

I am also about half-way through this one.  One night I had BBC on and the book open and it was hard to tell the difference between 2003 and 2017.  As a journalist for World Magazine, Belz traveled into Iraq and Syria when few others were willing, and tried to preserve the story of the religious minorities.  She's also a really good writer.  

Next on the horizon:  more books by African authors, for the African Reading Challenge 2017.  Join me in reading 5 books this year set in Africa, about Africa, and/or by African authors.   I'll name my five soon.  One will certainly be the next Rwendigo Tales book!

Happy reading!

Believe

It is the darkness of the situation that makes belief a necessary prerequisite of walking in.

A week ago, Scott landed in San Francisco to navigate his dad's failing health and his mom's anxious grief and his own weighty loss.  The first few days carried little clarity.  Confusing options, conflicting advice.  Tomorrow, however, he will begin his journey back to our home in Kenya, with much peace.  A lovely and reputable care facility with an opening for his dad; solid steps accomplished by his mom and him; hours upon hours of work and listening unfolding in progress.

A week ago, I was slogging through my first days back at work after our trip, the massive influx of patients who had waited through a more-than-three-month delay in care filling every bed at least double.  One day I noted that the Newborn Unit number (39) and the Paeds ward (61) exactly added to 100.  When you have a hundred patients being cared for by a team who resents return, who feels betrayed by the government and is talking of their next strike, who view medicine through demoralized eyes and dream of alternate careers, who come late and leave early so all work has to be compressed into a 3-5 hour day . . . well, you have to rush.  You desperately try to find the impending disasters and stave off the nearest deaths.  In the last 9 days we lost 9 patients: a 6-month old with Down Syndrome whose critical heart lesion had not been previously noted, a malnourished 3 year old who may have also harbored a malignancy, a 520 gram (1 pound) 24 week preem who tempted us to hope when she was perky and pink for two days, a 1.2 kg (2 1/2 pound) 28 week preem who looked desperately starved for air from day one but lulled us into thinking he would make it after ten days on CPAP (our bubble improvised oxygen delivery under pressure), an infant with croup who seemed to be responding to treatment and then was dead, a convulsing baby whose difficult birth left her brain damaged, a child with cerebral palsy who could not shake a severe pneumonia, a newborn with signs of a congenital infection causing heart and bleeding problems, and another baby the intern texted about because she didn't see why the nurses wanted to admit and next thing I heard the baby had died.  Add to that pummeling of futility some serious push-back from resentful residents and the lingering potential that it could all implode again . . it was dark.  Today, however, no one died.  We had reasonable round with some good decisions and teaching; we found abscesses to drain, a culture-positive meningitis, x-rays most likely showing TB, new diagnoses of AIDS.  The trainees joined me for chai and a talk on Down Syndrome.  A taxi driver we've used texted me for help and I got to see his perfectly healthy just-delivered daughter.  A nurse I respect took a photo to show me a nearly chubby (more than doubled in weight) return of a baby we had admitted a couple months ago.  My pediatrician colleague, my sole Kenyan counterpart, returned from a training course that had immediately followed the strike, and with her diplomatic skill and equanimity ironed out a better schedule for our team to function.

For both of us, I think God was asking for us to believe, in spite of the darkness.  Like the official in John 4 who had to take Jesus at his word about his son's distant healing, then went on his way home to be met by the news that the change occurred at the very hour of his ask to Jesus. (That story really struck me this week, as we ask for our children to be healed, protected, comforted, blessed from a very long ways away, and God gave me a glimpse that this is our story too).

The new moon is a falling tinsel sliver that dips into the sunset, leaving the nights dark right now.  This is the Lenten season where darkness fills the horizon, the cross looms large, evil seems to sway.  This is the season when we can only walk by believing.

Another unexpected turn in the road

For those who are not on our email update (mailchimp) chain, Scott flew emergently to CA this week the day after we returned from Burundi, to be with his parents.  The slow decline of previous strokes and dementia was punctuated by a new episode of bleeding in his dad's brain a few weeks prior.  His mother had the house modified and hired a full-time helper in order to care for him at home, but after just over a week of trying this arrangement it was becoming abundantly clear that the situation was neither safe nor beneficial for either of them.  Scott offered to come help; his mom jumped on the chance.  In the 12 hours between reserving the ticket and arriving back in Kenya, Scott's dad landed back in the hospital with another arrhythmia episode.   So Scott has been in Half Moon Bay since Thursday.  We pray that over the course of the next week he and his mom can sort out a nearby nursing home or hospice-care facility.  He's been setting up appointments to evaluate potential places, and working with the doctors to pare down the ballooning list of medicines his dad was put on, many of which he does not tolerate well.

We are grateful for the times that God has enabled us to be with our families in times of crisis.  We know our parents pay a very, very high cost for the work that we do.  We are more thankful than ever for the good visit we had in January; when Scott arrived this time, his dad did not recognize him.  That is a painful milestone.

Many of you have similar stories, and even living in the USA it can be challenging to be working, supporting parents, supporting young adult children.  This is a season of life, and we pray that by grace we can walk through it honoring those we love so much.  Thanks.

Addendum:  Check the two previous posts for Scott's excellent photos and some broad strokes on our recent trip to DRC, Uganda, and Burundi.  And . . .
The paragraph below was in an email from Heidi L, a dear friend, and so meaningful I had to share it with you.

When I would talk to my South Sudanese friends about my mom and her deterioration, when they would ask how she was doing, after I would tell them, their response, that rang in my head and heart for the whole time she was sick and after she died, was “Rabuuna fi.”  Literally translates to something like “Our Lord Is in”…”fi" can mean "is here" AND "is there” so it always was a kind of “I AM” statement for me…Our Lord Is.  He is with you, He is with your dad, He is everything you need and everything your dad needs your mom needs Caleb needs Luke needs…He Is.

Rabuuna fi, friends.

Heidi