Kenya Elections Tomorrow: A Timely Transfiguration Celebration

The 7th of August.  Here in Naivasha the shops are open, carpenters plane new bed headboards by the road, families cluster at the hospital gates, nurses change burn dressings, cleaners push mud off the sidewalks from a cataclysmic downpour last night, boda drivers buzz too fast down the paved roads.  There is a somber undertone of expectation and uncertainty.  But no one looks particularly bent upon evil.  The campaigning is at last, mercifully, over, and now it is just a matter of waiting for the polls to open tomorrow morning.

 My pediatrician colleague and I did the work of our usual intern team of 8 today . . thankfully not too many patients. Scott was similarly lonely but plowing on.  Except for government workers laying low and traffic being light, the day progressed normally with calculations and examinations and putting in lines.

And if one only sees the surface of the ordinary, tomorrow's election can seem more momentous and dangerous than it should.  Which is why the Transfiguration Day in the church calendar arrives at an auspicious moment, trailing the shimmer of Daniel 7, Psalm 97, and Luke 9 . .  "His throne was fiery flames . . a thousand thousand served him, and ten thousand times ten thousand stood attending him . . to him was given dominion and glory and kingship . . that shall never be destroyed . . the earth trembled . . mountains melt like wax . . light has sprung up for the righteous . . and while he was praying the appearance of his face changed, and his clothes became dazzling white . . and they were terrified as they entered the cloud . . "

No matter what happens tomorrow, the reality behind the surface of this world remains the same.  God reigns.  

We see the squabbles and the poverty. We see the crumbling pavement and hear the complaints of striking workers.  We read the news, the accusations, the missing funds, the political murder.  But today we remember that this is not the full story.  There are also moments of transfiguring glory when the Newborn Unit mothers gather to sing praise songs,  and one is bathing a baby who was abandoned, shining selflessness. When people find a reason to laugh in spite of not being sure of their safety tomorrow.  When we pray with believers who love their country.  Because behind this whole sorry beautiful mess is a true weight of glory that would burn our eyes out if we could truly perceive that dimension.

In Job, and elsewhere, when God wants to remind us that we don't get the whole view, that we are underestimating eternal power and love, we are told to look at the created world.  So let's close this last pre-election post with some of Scott's photos from walks to the lake that defines our town, and remember that love and beauty and strength will carry the day.

One Tribe?

Elections in Kenya: two days away.  We wove through cheering crowds and blaring buses yesterday as the campaigns reached their finale.  After the murder of the man in charge of IT for the IEBC (the independent electoral commission), fear and doubt have gripped more hearts.  The day after the news broke, we spent the evening at a neighbor's from church, praying for the country, for the leaders, for the people.  The trainees have mostly departed from our hospital, claiming fears for their safety since Naivasha has been volatile in the past, or a need to be in the town where they registered to vote before being assigned here. The county health department insists that we should provide full services in spite of a nursing strike and a dwindling workforce, and we spent too many hours in the last week trying to be voices of planning while knowing that people were just going to leave anyway.  Our teams at mission hospitals have tried to absorb more of the patient load, though many can't afford even those reasonable rates.  Every evening helicopters buzz overhead as the highest politicians whizz back to their Nairobi estates after campaigning.  Every day small trucks, buses, vans covered with posters and blaring loudspeakers from the roof cruise the roads, extolling the virtues of their party.  Every space that can be covered is plastered with posters.  Every billboard carries another face, another slogan.

It feels like the long inhale, when we all look around and wait to see what will happen.

And most people we talk to here assume that what always happens will happen:  people will vote along tribal lines for their candidate, and alliances between the largest groups will hold, and are so close to equal, that the outcome depends on which alliance achieves a hair's breadth greater voter turnout.

Ideas, policies, economy, constitution, devolution, corruption, strikes, reforming health care . . . all of these important things have very little impact on the election.  In this place, you vote for the person who will protect you from being sidelined and marginalized, who will ensure the flow of privilege to the people most like you.  

Which, if one thinks about it, seems to pretty well characterize the last American election as well, and perhaps is a deep human truth.  We live in a limited-resources fear that we have to band together to help our kind, and our suspicion and fear grows in proportion to the differences we perceive.

So this morning's passage in church "happened" to be John 17, Jesus' prayer for his inner circle of followers and those that would ripple out from the resurrection.  Jesus knew that the coming hours would mean a seismic shift in reality that would affect every tribe and tongue.  And in that moment, the theme of his prayer:  that they may be ONE.  This week as well, I'm finishing a commentary on Romans, and the latter section of that book grapples with the impending divide between the nucleus of Jewish Jesus-followers that expands to embrace a variety of gentile cultures.  How can the community hold together when cultures collide?  We missionaries stare into cultural chasms all the time.  A few are between us and our hosts, sometimes over subtleties (how do I weigh teaching personal responsibility as a clinician to trainees without invoking public shame), sometimes over lines-in-the-sand matters of justice (female circumcision as a cultural rite versus a way to disempower and control the sexuality of girls).  BUT MOST ARE BETWEEN US AND OUR FELLOW MISSIONARIES--matters of emphasis, personality, preference.  This group judges that group for not living simply enough, that group judges another for valuing lives-saved medical metrics over friendships-formed social metrics.

So, for the struggling church, for uneasy Kenya, for racially-unjust America, these are core questions that we ignore to our peril.  Are we one tribe?

Here are a few pre-election thoughts that I know I need to reflect upon, and ask God to teach me.

1.  Diversity is beautiful.  Kenya's 48 million people belong to at least 43 distinct groups, each with nuances of livelihood, building styles, marriage traditions, names, jewelry, dress, color, dance, music, arts, etc.  This diversity in unity reflects the Trinity, a God who is both one and yet so uncontainable that the world's billions each reflect in their own unique way.  In the church, or on a team, or in the body, we need unique gifts and roles to bless each other.

2.  Unity is essential.  Jesus prayed for it.  Communities and countries and our world depend upon it.  We must collaborate to care for each other.  To grow and distribute food, to build houses, to educate our children, to protect our families from thieves and our countries from dictators.  Kenya's resources of people, ingenuity, land, sky, wildlife, minerals, and on and on require collective cooperation to manage in ways that bless all.  The church also needs to lean into each other with our gifts, to be strong enough to make the blessings flow out to the world.

3.  It's not a choice of my tribe or yours, an either/or limit . . . it's a truth of both/and.  This is the paradox of our existence.  Terminal uniqueness means I can't relate to anyone, I always have to differentiate myself.  Yet assimilation also brings loss.  In our best moments as humans we celebrate the brilliant gifts and colorful surprises we find in others, and we embrace those others as part of our larger community.

Please pray for Kenya over the next week.  Pray the polls on Tuesday will be managed with transparency and safety.  That the votes will be counted truly.  That the people will have confidence in the process.  That the inevitable losers will accept the result, that the inevitable winners will look beyond themselves and work for the good of all.  That this country, and our country, and the church, and humans in general will take the words of God seriously about valuing difference and working in unison.  That we may be one.

Eat this book

Ezekiel is a good read.  For one, as we live in a world of uncertainty at the whims of political maneuvering and the violence of angry fearful humans, it reminds us that this is not a new situation.  Yesterday news broke in Kenya that a senior official in the independent agency that runs the elections (as in importing ballots, securing polling stations, counting votes) was tortured and murdered.  The unease is palpable.  Yet God's people over time and across the world have almost always lived in less than ideal security situations.  And even in times of invasion, exile, and injustice, God reminds them that the whole world is in His hands.  The prophets continuously not only call for repentance, but also give glimpses of the trials ahead.  Then when those come, people are less surprised and more resilient.  Oh, the temple is being destroyed, but we know the bigger picture, God can still bring about good.

As a book devourer, I can relate to the graphic picture of eating a scroll that tasted like manna, a honey flavored wafer.  Books sustain, warn, enlighten, cast light, show paths, give previews to what may come in life.

And last week, I got the AMAZING TREAT of seeing my own books do just that.  We hosted a family whose hearts God had stirred to explore working in rural Kenya, at a struggling mission hospital, to boost the Kenyan colleagues who are leading the work, to train others, to embody the Gospel. All very inspiring, but they also have an 8 and 12 year old.  How can kids make the transition from American heartland life with its state fairs, soccer camps, school plays, library trips, tight-knit church communities, accessible grandparents . . to life in the Kenyan tea fields with mud-floored schools and donkeys carrying water?

Well, it turns out, eating a book can be a start.  Our first night together we went on a hike down by the lake, and the 12-year-old alertly warned us of mpali, the biting soldier ants, crossing our path.  How did he know?  He'd read about them in A Chameleon, A Boy, and A Quest.  While parents toured the hospital, these kids eagerly went to see various school options in town, all a far cry from their previous experience.  How did they process that?  Well, the schools reminded them of various scenes from A Bird, A Girl, and A Rescue.  A wagtail features prominently in that book, common in Uganda but not often seen around us here in Kenya.  So it was a kind touch from God when one hopped on a wall right behind the 8-year-old as we ate lunch on almost our last day. (By the time I whipped out my phone you can barely see the bird in grass to left . . )
 

In September, the third book in the Rwendigo Tales series will be available:  A Forest, A Flood, and an Unlikely Star.  It's a good read for the plot, but watching these two kids encounter Africa for the first time gave me a different hope.  If kids can read about Africa in stories that enfold the hard parts in the reality of adventure and hope, if kids can relate to other children grappling with poverty and hunger as likable fellow humans, if kids can recognize what might have felt foreign as familiar . . there is hope for our world to grow a bit more solid, connected, strong.

PS Also available on Amazon in paperback or KINDLE:  Tale One, Two, and Three.

And July is a wrap . . . what will August bring??

The second half of July:  a pretty solid pace of the main areas of our life.  Patient care working at Naivasha SubCounty Referral Hospital, hours of phone calls/skype/meetings with our supervisory role at Serge, and hosting current and future missionaries.  So here's a little photo wrap-up of the month, from my phone.

Clinical work: Naivasha Hospital and a touch of Kijabe

In spite of two months of a nursing strike, which now threatens to drag on just as long as the doctor strike, Naivasha tries hard to stay open.  That means hiring short term contract nurses and stretching them thin, limiting but not closing admissions, which puts everyone in a difficult position.  If a patient is told to go to "hospital of choice" they often just get sicker and come back as an emergency.  We've seen many many lives saved in this strike, as the small crew available works hard.  But Friday we had one nurse covering about 25 babies . . . no surprise that some fluids didn't get given, or medicines were delayed.  Still the interns/trainees are coming, so we teach, round, prescribe, intervene, put in a line, do a surgery, order labs, overview care.  Here's the bustling newborn unit:

Baby A has nearly doubled in size from 880 grams, 26 weeks gestation, to 1590 grams six weeks later, her entire life lived during the nursing strike.  She's a sweet little miracle that would not have survived anywhere else in Naivasha.

These three look pretty cozy . . in spite of being almost two months early (32 weeks gestation) delivered by an emergency C/S after their mother developed a severe complication of pregnancy known as ecclampsia, with seizures and failing organs.  They were a little touch-and-go blue and floppy as Scott pulled them out and handed them off to me and my two clinical officer interns, but this photo was snapped at about ten minutes of age, with everyone breathing well.

And crazy enough, they were our second set of premature triplets this week.  They joined even smaller 30-week triplets whose mom arrived in unstoppable labor and delivered them naturally on Monday.  The six of them are in two side-by-side incubators (blue lights for jaundice).

There's also the usual rush of convulsing toddlers, HIV-affected families, pneumonias, TB, sickle cell disease, severe dehydration, injuries, swallowed kerosene or pesticides, hepatitis, unexplained paralysis, difficult delayed labors, breech deliveries, overwhelming infections.  And a newborn baby found abandoned inside the muck of a pit latrine covered in maggots, who is holding on.  Naivasha is a place of last resort for the desperate, a place to take a stand against evil, and a place to encourage others who are doing the same.

And not all our patient care is at Naivasha--recognizing that the strikes put pressure on the mission hospitals, we agreed to take call at Kijabe once a month through this period.  It's a treat to reconnect with our former co-workers and to refreshingly embrace a system where labs get done and interactions are cheerful.

And kids are very sick and very complex.

Serge Area Director Work

Well, photos of meetings by phone are limited here, even though that work is important.  With ten team locations in four countries, plus a former/hopefully future 11th/5th for South Sudan, we spend a good chunk of each month communicating with team leaders, reading, writing emails, meeting virtually.  We enjoy the privilege of walking alongside people who are living for Jesus in challenging places, even when that means they also deal with discouragement, spiritual warfare, miscommunication, legal challenges, difficult partnerships, mental health setbacks, loneliness for family left in the USA, brewing insecurity.  Our hearts are scattered about in East and Central Africa.  And as God draws more people to consider joining, we find ourselves exploring new sites, hosting, dreaming, helping to develop vision.  

This past week we spent five days with this lovely family whom we hope will be returning as a nurse and nutritionist for Litein, working clinically alongside the Kenyan team and teaching in the nursing school there.  Here they are by Lake Naivasha, on a walk from our home . . . 

And at Litein hospital, which it turn out was founded by a missionary almost a hundred years ago with their SAME LAST NAME (he planted this tree) . . 

While the parents and Scott and George Mixon met with hospital leadership, toured, went on rounds . . the super trooper kids and I explored four different Kenyan schools in town, and the market.

It is no small matter to move from a life in the USA to consider a life in Kenya, so we pray for God's clarity for them and another couple who was simultaneously visiting our team who works with inner city unreached people from a neighboring country.  These visits involve a lot of good Kenyan food, so here we are sharing a lunch with the Litein staff:

Lots of car hours seeing Kenyan countryside . . . 

And back to Naivasha in time to welcome our Bundi Team Leaders, who in the best Bundi TL tradition are having there second child here in Kenya this month.  Pray for a save delivery!

And the rest of life . . . 

In between caring for patients, teaching trainees, recruiting new workers, and supporting teams . . . life fills the hours left.  Shopping, cooking, walking the dog, neighbors, and family phone calls.  This blog from Serge popped up again on my facebook, and expresses well one of the greatest struggles of this season of life:  

By following God’s invitation to international mission work, we extend an invitation to our adult children and parents to find more happiness in Jesus than in the comfort of family. 

That, friends, is a difficult and inconvenient truth for sure.  Our sisters, our mothers, our kids pay a high price.  So it's always a treat when we get snippets of their lives by texts, photos, phone calls.  And when they get to support each other.  C got an unexpected and sudden week of leave because his regiment is likely to deploy soon--not enough freedom to come to Kenya to see us, and we couldn't come see him, and that was SO HARD.  But his big brother pulled him into his own life for a week, a true blessing.  Plus he sent us photos.  What a good brother.

J finished her two month internship in Jordan with a party from her environmental project coworkers:

L heads into two months of intensive sub-internship rotations in orthopedic surgery in New Haven and Cleveland, starting tomorrow.  And our youngest is immersing himself in New Zealand student life, from engineering classes to backpacking.  There was a MOMENT ON FRIDAY when we were all on a Google Hangout at the SAME TIME (L not pictured but in back seat holding the phone that shows C).  Our time zones span 20 of the 24 hours in a day, so it's no small feat (aided by the fact that a certain college student is alert at 2 or 3 am in his time zone).  

Our church provides us with community, fellowship, prayerful encouragement.  I often play the keyboard, and today Scott was asked to lead the service.

So what about August???

These are three of the little lives who would like to know (Scott's photo, at a few hours of age).  Kenyan elections are set for August 8.  The entire country is sorting itself into tribal groupings, as people return to their ancestral homes to vote,  and to ensure their safety from other tribes.  Ten years ago at least a thousand people died in post-election violence stoked by politicians.  Tens of thousands were displaced.  This cycle we read of riots, youth attacking rallies, thugs taking advantage.  There is an edge of uncertainty.  ALL OF OUR FELLOW DOCTORS (consultants, medical officers (like residents), and interns) have told us they will not work the week of the elections.  Where does that leave our patients?  Particularly with the ongoing absence of nurses?  We hope at least a skeleton crew will remain of clinical officers and short term nurses, for the sake of the babies, the emergency deliveries, the poorest patients without other options.  Please do pray for peace.  Our sermon today was from John 16.  In this world you will have trouble.  But be of good cheer, I have overcome the world.  Pray for all of us here in Kenya to see that promise of Jesus pervading the country, overpowering the evil of men.

As a bonus for reading to the end, here are the 8 paintings done by the Shirk's niece, on the wall of the Paediatric Ward at Kijabe, lovely portraits that honor the patients we care about--

Earth has no sorrow . . .

This, friends, describes the heart of who we want to be.  A place to bring wounded hearts and bodies, to tell the story of all the sorrows, to find the healing of Heaven pouring down to earth.  So much of that healing comes just by gathering and telling.  And the rest comes by a dimension beyond our wildest dreams pouring, seeping, dripping, splashing over into our broken world.  

So begins another week.  The nursing strike continues.  Babies born at private clinics (private sounds ritzy, but in Naivasha generally means for-profit but not necessarily best-practice care), then bundled over to our Newborn Unit which tries to remain functional.  Four died Sunday.  Four.  Another Monday.  Coming too little, too late, too damaged.  And often passing through hands that don't recognize the dangers. Scott and I keep showing up, keep trying to give input and model compassion and a level of diligence that might make a difference.  Some days it feels futile, or like an uphill battle.  Some days we clap our hands--our 880 gram 26-weeker hit 1290 grams and 31 weeks now.  Another preem who had intractable vomiting and feeding problems for well over a month reached her due date, still tiny and vomiting . . we stopped all her medicines and just had her mom breast feed and hold her.  She's ready to go home today.  Last night on our what's app group, one CO intern got the baby in this picture a spot at our main referral hospital in Nairobi, Kenyatta, for evaluation of her heart malformations.  An off-duty CO intern volunteered to ride in the ambulance with her late at night, since there are no nurses.  Small victories, of medicine and of faith, hard to remember in the face of so many tragedies.

This is a map of Health Care Quality and Accessibility gaps, the darker red the color, the more lives could be saved by provision of health care.  Kudos to the data people, those who try and collect it, process it, publish it.  We need to tell the stories, tell the anguish so to speak, as both real-life babies with names and photos, and as aggregate numbers that put punch behind the vignettes.  This map comes from a Lancet article published last week, distilling death data and health worker availability data from around the world all into an index with a single value per country.  The good news:  health care quality and accessibility are improving world wide.  The bad news:  the gap between best and worst, richest and poorest, is widening, and here on the continent of too much red, we feel it.  Here's a graph from the next volume of the Lancet, that shows how many lives could be saved by straightforward already-discovered health care practices, right here in Kenya alone.  Tens of thousands.

So, getting to the top of those bars, requires some telling of the anguish and some healing from Heaven.  Some collaboration and education and rainfall and good governance.  Some attention and prayer.

First, pray for the upcoming elections.  The nursing strike, the general health care crisis, won't be resolved without strong leadership.  Pray for Kenya and America, to choose leaders who consider others' needs before their own power and advancement.  This was the scene in the grocery store Saturday--people stocking up on maize-flour to be sure they can make ugali, the staple starch, if the elections turn violent and it all falls apart.  We bought a bag too; along with our normal fresh food we threw in some cans.  Our neighbors reassure us that all shall be well, but then we sense the palpable disease at the hospital where people from multiple ethnic groups work together.  Many will go back to their home areas to vote, both because that's where they are registered (aka Luke 2) and because that's where they feel safe.  The elections are scheduled for August 8.  Every day there is another crisis that throws the whole process into doubt.

Second, pray for our partnership and friendship.  These two women I work with reached out to say they wanted to get to know us better.  I invited them for lunch.  It takes time to build relationship in a new place, and the strikes have made that even more challenging.  But as much as we need solid laws and security to provide the stability for development, we need solid connections with real people to build the trust and common vision for lasting changes.  And to keep our weary hearts from giving up.  Theirs too.  

Third, pray for God to move more hearts to help.  We're thankful for our overseas partners who pray, who give, and those who are moved to come.  Note the old CPAP improvised out of a cut water bottle and a lot of tape, with the re-used-forever dingy tubing on the right.  On rounds yesterday we noted once again that there wasn't enough water in the bottle to bubble; that the baby was struggling.  So we replaced it with new supplies brought by two NICU nurses.  Wala.  The spiff clean blue-topped bottle to the left in the photo, where there is a clear "fill to here" mark, and big numbers to dial the depth of the brand new clean clear tubing.  Hooray.  We need supplies, but we need people more.  People willing to be the community in Moore's quote, to move into hard places and invite their neighbors to bring their anguish, to tell their stories.  People willing to be channels of God's healing through truth, through education, through practical services like water and food and medicine.  Aren't sure where you fit?  Fill out this form and Joanna will help you, and us, figure it out.  

This is a lot to believe some days.  But it's something we stake our lives upon.  I like the double entendre of this water drop, a tear most likely representing sorrow, but like Psalm 126 the tear drop can also represent the life-giving water, healing, bearing fruit, the flow of blessing.  The last month I've been reading a commentary on Romans, and comparing it to current events and the tragic history of this continent.  Our world teaches us that to be in power is to force those "below" to serve, so that all that is desirable is pushed upwards to the few.  Jesus turns that upside down, and says Israel the ethnicity and Israel the new broader all-welcome people of God are to be conduits of blessing that flows out, floods down, serves and waters and heals the world.

Including Naivasha.  And Kijabe, Nairobi, Chogoria, Litein. Fort Portal and Bundibugyo.  Nyankunde and Bunia.  Bujumbura, Kibuye. Mundri.  People we love, places we long to see healed.