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Wednesday, September 08, 2021

Update #4: 8Sep 9:20pm EDT


UPDATE #4: WEDNESDAY 8 SEP 7:00pm

Not much to report since the midday update.  


Jennifer continues to respond to the nurses as they perform hourly “neuro checks” - “Open your eyes; thumbs up; squeeze my hands; wiggle your toes; push your toes against my hands; pull your toes against my hands.  Ok thanks.”


And then there are the occasional spontaneous awakenings which we treasure.  This afternoon, while I was talking to my mom and sister, Jennifer suddenly woke up (meaning: she opens her left eye and looks around without moving anything else). I showed her my phone on FaceTime and she WAVED at Sonja and my mom on the phone (waving her hand—but not lifting her arm which is tied down to prevent her from removing her ET tube).


Afterwards as we again recounted the events of the past 48 hours to her…she grimaced as she processed the facts. Hard but good to see the processing.


Tonight she will undergo an MRI of the brain in an attempt to further understand what is going on inside her brain.  


Tomorrow we hope that there will be further improvements in her wakefulness which will allow her to fully breathe on her own and get off the ventilator.  Keep praying.




Update #3: Wednesday 8Sep 12:05pm

 

UPDATE #3: WEDNESDAY 8 SEP 12:05pm


The night shift reported no significant change to her mental status, still sleeping most of the time, but passing neuro checks when stimulated.


When we arrived, we felt a bit discouraged because she did not really respond to our voices or rubbing of her hands and feet—BUT THEN…


She had one of her intermittent lucid intervals which was so encouraging:

 - We covered the left eye (good one) and she was able to count fingers with just the right open (she held up the same number of fingers on her hand as we put in front of her eyes). ANSWER TO PRAYER.

- She is moving her lips and seems to desire to talk. Exciting.

- Jennifer clutched her chest and seemed to be trying to communicate something. So we put a pen in her hand and she was able to scribble out three letters (C-O-U…) which we were able to interpret as COUGH.  Got nursing to suction a lot of mucus out of the endotracheal tube.  Evidence of cognition and communication! ANSWER TO PRAYER.


The ICU Team and Trauma Teams round on Jennifer independently.  

The ICU Team is primary and they are the ones responsible for the ventilator management.  They have a couple of strategies for trying to get her to wake up more (medicines…I wanted to suggest espresso, but restrained myself).  We’ve been cautioned to continue with patience as an important strategy.  So we wait.  


I asked the Trauma Surgery Chief where Jennifer lays on the trajectory curve of similar head trauma patients and she said she is ahead of schedule.  It typically takes days for similarly traumatized patients to wake up.  That has been a great encouragement this morning.  We do see progress, but it is incremental.  


So…slow progress.


Prayer Requests for today:

  • Continuing healing in the brain
  • Incremental wakefulness
  • Weaning from the ventilator


Thank you to all who are praying and sending encouraging messages.  We have been FLOODED with notes of encouragement and prayers.  We read them all.  We treasure each one. We gratefully acknowledge our dependence on your prayers for Jennifer’s healing and recovery.  We look forward to the day when she will be able to read each one for herself.

Monday, September 06, 2021

PRAY FOR JENNIFER! —Edited — Update #2–Sep7 10:00pm

UPDATE #2: TUESDAY 7 SEP 10:00pm

The hospital’s COVID policy does not allow for visitors staying overnight so we’re back in Buckhannon getting a night of rest.

This afternoon was a long game of waiting by the bedside for brief minutes of consciousness between long periods of sleep. In her responsive moments she seems to understand who we are and respond to some yes/no questions. She is passing neuro exam with flying colors - squeezing fists, pushing and pulling with toes and fingers, and even giving two thumbs up on command. But we’re disappointed that she is still not breathing on her own. 

Please continue praying that tomorrow she will improve enough to come off the vent.  Getting the endotracheal tube out will allow her to speak and then we will have a much better idea of her level of cognition and memory.


UPDATE#1: TUESDAY 7SEP 11:30am

Writing from the NCCU (NeuroCriticalCare unit) in the UniversityHospital WVU.

Since I last wrote 11 hours ago—here’s what I know.

She’s had a total of three Head CT scans.  Essentially, the reports are “no change” — which is quite good news.  No progressive bleeding.  There’s also no evidence of worsening swelling (edema) of the brain.  So, the imaging data is encouraging.

That said, there are still a couple of big issues.  Her mental status is still quite impaired.  She ranges from “somnolent, but following commands”—opens eyes and moves extremities to commands—to “responds to pain only”.  She is still on the ventilator and has failed a couple of attempts to allow her to take over and breathe entirely on her own.  This seems to be normal experience in the ICU.  But we really need her to wake up more and start breathing actively.  She has been completely off sedation for the past 12 hours so that does not really explain her impaired mental status.  Once she gets off the vent, it will be easier to evaluate where she is at cognitively.

Second major problem is the right eye.  The ophthamologist was able to get her to cooperate enough to follow his finger to evaluate her eye movements.  She has impaired ability to gaze medially, upwards and downwards — which in combination with the dilated pupil and droopy eyelid indicates involvement of the third cranial nerve. Not sure where.  This nerve originates deep in the midbrain and snakes up through the brain to the eye.  Is there a collection of blood impinging or irritating this nerve—or could it have been injured from the extreme deceleration forces? We don’t know.  When she is extubated, the eye docs can better assess what vision she has in that eye as well.

So, prayers…

- The “no more bleeding” prayer.  Check.  Thank you, God.

- Still need prayer for getting off the vent; for preservation of cognitive function; and for the right eye.

All for now.  Hope for another update later today.

—————————————————————————

ORIGINAL post — 6Sep evening.

Scott here.

While out on a bike ride this afternoon —our last day in West Virginia before heading to our Area Director meeting in Philadelphia—Jennifer had a terrible accident.  She flew over the handlebars landing on her head on the pavement—but she was wearing a helmet and that undoubtedly saved her life. Thankfully a number of Good Samaritans stopped to help stabilize her.  Thank God for Emergency Medical Services.  Medical Ambulance and Fire Rescue vehicles were on the scene within 15 minutes.  Due to some abnormal neurologic signs (dilated right pupil) an immediate decision was made to bring a Medivac helicopter to take her to the Regional Trauma Center at the University of West Virginia in Morgantown. That arrived another 10 mins later — transporting her 65 miles north in a matter of minutes.

It’s been a long six hours.  She’s had 2 CT scans showing a subarachnoid hemorrhage.  Her responsiveness was deteriorating after arrival in the ED so she was put on a ventilator and continues to have ventilatory support.  She’s gotten hypertonic saline and mannitol to reduce brain swelling.  

The dilated right pupil is very concerning.  It’s a sign often indicating pressure on the brain from a hematoma putting pressure on the brain—which she doesn’t have.  There is some evidence on the CT that there is bleeding involving the optic nerve.  The outcomes here include permanent blindness, return to normal vision or something in between.  

The care has been outstanding.  The ED Trauma Team is a coordinated machine.  Efficient, calm, professional, competent.  And caring.  

We are so thankful for the outpouring of love, concern and prayer.  

It’s a battle.  The outcomes are uncertain.  

Pray for:

- getting off the ventilator

- healing of her brain—and no more bleeding

- healing of her right eye

- a complete return to normal cognitive function and memory

Thank you all.

Saturday, August 28, 2021

Faith in the era of COVID prevention: has anyone read Leviticus?

 Yesterday, we drove 8 hours to Entebbe with our vision-trip site-visitors so that we could get COVID tested prior to travel. Travel in the era of COVID has become quite an ordeal. First, the flights are fewer and frequently canceled . . . a day before one can be told, sorry, we moved you to another flight (which has happened to 10/16 people we've had departing this month). Second, there is a continuous fluctuation of regulations as borders open and close, quarantine rules tighten and loosen, countries retaliate against bans with more bans. So a connecting country can decide not to allow people to land (2/16) or require more paperwork (16/16). Then there is the fact that absolutely international travellers are the vectors of COVID, so it is 100% essential that everyone is rigorously tested. All of us need to get PCR results (which takes a minimum of 24 hours) taken not more than 72 hours prior to take off. In the old days we often drove straight from Bundi in the early morning to access a night flight; now we need to add in a day to get tested and wait for results. In the process we have to be continuously masked, and there is always the anxiety that we would pick up the virus en route and inadvertently bring it to vulnerable people. The sheer emotional toll of planning a trip, purchasing tickets, making promises, getting up hopes, in order to attend a meeting or see lonely parents . . . only to have it all hang on those negative test results, spending the days and effort to get ready to go yet never being sure we actually can . . . 

It's a lot. 

The mobile tester

next-day GOOD NEWS

And yet, we do it with trembling tenuousness, and then rejoice when it works out. Because we don't have a right to zip back and forth, yet doing so allows us to be part of our organisational leadership, and allows us to stay connected with our immediate family members. It allows us to first, do not harm, at least to the best of our ability.

When I look at Scripture, I see so much support for public health. First, Jesus summed up the whole law and prophets as love God and love your neighbour as yourself, which he then expounded into the story of the Good Samaritan, where loving your neighbour means a pretty huge dose of inconvenience, sacrifice, expense, even danger. Love looks that way: curtailing your individual desires for the good of someone else. JD Bartkovich used to tell us that Leviticus was her favourite book. It tells people who can go where, who has to isolate and stay home, how to be purified, how to prevent the spread of disease. All essential to the capacity for a nation of former slaves to move in tents through the desert as a group. It's a whole book of limiting your own freedom for the good of the whole. That's how God's people should live. Yes, being created in the image of God surely gives us individual dignity and capacity and freedom. But being created as humans in community puts some limits on that freedom. Don't kill, don't steal, let all that you do be done with love.

So we get our vaccines, (which is actually not at all sacrificial, it's self-protective, since the risk of an adverse event is about 1 in 100,000 (no death, just temporary inflammations) with vaccines and of serious outcome after COVID disease is about 1000 in 100,000 for death and 10,000 in 100,000 for being in the hospital). We wear our masks, and meet outdoors, and keep some distance. These are not hugely unreasonable asks in a year in which 4 million people have died of a new infectious disease. 

Even if the ask was much harder, and the risks were much higher, people of faith should be on the forefront of being willing to bend their personal freedoms towards the greater good. I think that's what Jesus meant by taking up our cross, after all.

(PS - traveling with Regan and Jack S to Entebbe airport after a whirlwind week Vision Trip —potential future teammates!?) 

Thursday, August 26, 2021

Smouldering Wicks

These COVID eons, we talk more often about burnout. This week we filled out a survey for a friend's research, which is the second Serge colleague doing such a project. I read an article this week too, about burnout amongst non-physician health care workers that identified high emotional exhaustion and depersonalisation as risk factors for quitting. 

But in that article, organisational satisfaction was protective. And the surveys have heightened awareness that along with Sabbath and spiritual rhythms, good exercise, sleep, and dietary habits, the way we smouldering wicks avoid becoming dumpster fires and then piles of ash is . . . community.


So today, a small ode to team.

We have a couple visiting this week (Dr. Jack and Regan seen by Scott above) and as Scott and I talked about what kind of cross-cultural medical situation they might choose for their life, what would be best for their family, how they would react to the bottomless swamp of malaria here, the interrupted supply chains, the intermittent power, the inadequacy of staffing, the sorrowful deaths, the immediacy of majority-world realities we'd rather not confront hour to hour . . . well, it's a lot to ask someone to embrace. But then Scott said: they won't find a better team to be on. 

So much comes down to just that: the person beside you in the trench.

(L to R) Mike who brings together pastoral Bible depth and accounting competence, which is a perfect but rare missionary skill set. Kacie who has plunged into learning preemie care in NICU and bravely got her Ugandan nursing license. Patrick who came to lead staff development at Christ School and has weathered school being shut down more than in session so far, but redeemed the time with literacy camps and discipleship. Alexis who ended a decade mom-induced teaching break to dive into Rwenzori Mission school. Michaela who has poured her heart into making Kindergarten and 1rst grade pinnacle educational experiences. Ann who connects us all to the community with her endurance and approachableness, and pioneered an environmental education and discipleship camp this summer. Laura who agreed to trade teams from Kenya to Uganda at the 11th hour and somehow seems to be picking up Lubwisi as fast as she is coming up to speed as a middle school teacher. Josh who hikes hours every week to bring a clean water system to marginal people, and Anna who smiles like that even when her kids don't sleep and she's teaching preschool. And then the visitors, and us. We've had our stressful times negotiating COVID protocols, grieving losses, stepping on each others' toes, having to share cheese and freezer space and rides and data. But over the last couple years this team has gelled into an imperfect gaggle of humans who care about each other and the world.

And it's not just this team, but also our colleagues and neighbours. Last night the Christ School teachers were commenting on how much they appreciate their family-like support for each other, as they joined in a gift for one of the staff member's new baby, and another announced an upcoming marriage. Our nutrition team cared so well for the one who got COVID. Dr. Amon and the hospital team work incredibly hard; as Nusula the charge nurse just said in the staff meeting, we have double the normal census but no increase in deaths on the ward. Yes.

With vaccines and the airport open, we are now entering a season of "home assignments". Our Serge workers are given one year out of every five to report back to their donors, reconnect with family and culture of origin, rest and renew, update studies. We will miss the McClure family and Ann who fly out this week until January, and later the Forrests (Nov) and Dickensons (May). We want to hold onto stability; but the nature of the sojourner life is that people come and go. 

But Jesus does not. And Jesus was the very one whom the prophet Isaiah said 
"a bruised reed he will not break, 
and a smouldering wick he will not quench, 
until he brings justice to victory; 
and in his name the nations will hope."

So we keep smouldering on here, smoking glowing embers of the world as it should begin to be, dim lights that point to a new reality. Until justice wins and everyone has hope. Together.

Dr. Amon on the packed paeds ward

CSB staff meeting with COVID protocols for Bible Study

Team meal on our patio

Gathering this morning to pray for the McClures as they drive out

Building community with our interns

Going to miss my friend Ann!

The requisite pre-Home Assignment family photo . . . 

The NICU nursing team and intern meeting to discuss our work

Scott talking to Reuben, who has worked here even longer than we have!

Scott, Jack, Admin, Amon: hope for the hospital's future!

Beautiful Ugandan food fuels beautiful community

waving bye this morning to a core family . . . they will be back!

A sobering reminder that not everyone survives this shared vision. Dr. Jonah's grave in the Ebola memorial.



Sunday, August 22, 2021

Remembering the short, full life of Jack Shickel: 12 July to 16 August, 2021

This is the tribute being read tonight at Jack's memorial service in Harrisonburg, Virginia. Jessie and Ike were members of our team from January 2019 to June 2020, working to serve malnourished children and managing the workshop, grounds, maintenance, fixing of everything, youth, sports, and team support. When they finished their 18 month term they returned to the USA where Jessie continued to work part-time for Serge remotely and part-time in nutrition while Ike joined the family business. Their longed-for pregnancy finally happened but was fraught with a series of confusing scans that ultimately showed their son had a very under-developed left side of the heart. He was delivered about a month pre-term and underwent two major heart surgeries while staying on life support at UVA. So much love and prayer and yet . . . after 35 days Jack went to be with Jesus. Jessie asked me to write something for the family and gave permission to post it here. 

Family and Friends, we gather today to grieve the loss and celebrate the life of baby Jack. Yes, we can say celebrate, because his 35 days of life were beautiful and full of love and meaning in a way that others of us take decades to realise.








In 1 Corinthians 3, we read that this life is a process of being transformed from glory to glory, to become more and more like Jesus as we look more directly on his face. Romans 8:28 is a verse we cling to in times like this, that for those who love God, God works together all things into good. Not all things are good: evil is real, our enemy harms us. But God works IN all things FOR good. Verse 29 tells us that the good which God brings is specifically the work of conforming us to the image of His son. And in his 35 days, Jack was being transformed into the image of Jesus for all of us.


Today we want to remember Jack’s life through the lens of how his specific story reflects Jesus’ story, and how that helps us see meaning and purpose in his life and our own. The parallels start in the prenatal and birth saga. Jesus’ parents were under pressure, on the move, off-balance, away from home, and even had to flee to Egypt to protect him from harm. Ike and Jessie spent the months of Jack’s gestation under a cloud of diagnoses, and when Jessie went into preterm labor they had to also flee by night to Charlottesville for a birth away from home. They did this to give Jack the best care, the best protection that this world offers, because they loved him. In the vulnerability of infancy, Jesus and Jack leaned into the care of their parents to help them, and drew out depths of sacrifice and love.


Mary and Joseph, and Jessie and Ike, no doubt found the peaceful prelude days too few, whether 30 years or 5 days. Because then the suffering began and was relentless. 

Most of us only saw Jack through photos and short video clips, but we were struck by the way Jack on his ICU bed reminded us of Jesus on the cross. Isaiah 53 describes the suffering servant as one who was bruised, crushed, marred, wounded, unable to cry out. We saw Jack with his little bruised hands, his many piercings for lines and drains, his riven chest where blood flowed out, his heart literally torn, his breath literally struggling, his cries literally silenced. His family gathered and watched but could not hold him. 

Why? Not because he deserved worse than others, but because this entire creation is under the curse of sin and evil, and he was an innocent baby caught in the crossfire of a broken world. Jack, like Jesus, was born into a place where thorns and thistles grow, where life is filled with pain and loss, and he paid the price in his body. Because of all our sin and sorrow, Jack also experienced pain. And in all those days in the ICU, he still looked on his parents with recognition and love, he still felt the touches of their presence, he still wiggled and responded to them. In his baby way, he loved and depended upon his mom and dad and family and community, and they loved him deeply and truly. 


Yes, Jack’s life seemed short, but he intensely reflected the image of Jesus through and through. The meaning, the impact of his life cannot be erased or diminished.


Jesus’ friends could not wrap their minds around victory coming through such defeat. We all feel that today. Surely if Jesus was the son of God, He could have come down from the cross. Surely if God is good and powerful, He could have saved Jack, made his heart pump perfectly, his kidneys rebound, his lungs expand, his liver function, his brain safe. 


So with Jesus and with Jack, we look directly into the face of mystery. 


This is the holy ground where God takes us all. Evil is real and terrible and so horrifying that we can’t gloss over it with platitudes. And victory comes paradoxically not by avoiding death but by entering it. Life comes THROUGH death.


Jesus died. There was no 11th hour rescue of the type we prayed for night and day for Jack for over a month. But in that apparent defeat and loss and sorrow and misery, Jesus passed THROUGH death to life. The Shickel’s last view of Jack was him wrapped in a light white cloth, bundled like Jesus for the tomb. We have not yet seen Jack’s resurrection body. But we have the eyewitness reports of those who saw Jesus’s scarred hands and side on the other side of the grave. The wounds were there, healed but reminders of the cost of redemption.


Now we are in the in-between time, where we must walk by faith with our own scars. Jessie’s and Ike’s and all the Shickels and Johnsons and Carlisles and extended family and friends, all the Jack-shaped scars that will always be part of our lives. Jack lived a full life, he loved and was loved, he walked an unflinching path of imitating Jesus, and he suffered and died. Redemption is sure, but it does not erase the reality of the last month of hopes raising and crashing, of questions and doubts and fears, of joys and connection followed by tears and separation. Jack is now face to face with Jesus, but we are here looking through the glass darkly. 


And yet. 


We do have hope. The trajectory of Jack’s life, his sweet innocence, his suffering and death, did not end there. Jessie and Ike will hold him once again. All we who are gathered here will be reunited. Love is stronger than death. The end of the story is still to come, and it is good.


Jessie and Ike, on behalf of the great cloud of witnesses who have walked with you from near and far, we close with saying that we are still in this story with you, crying out and yet holding on. We love you.






Thursday, August 05, 2021

SERGE INTERNSHIP BUNDI 2021: uncomfortable, stretching, and deeply good

 Not to brag, but one of our interns wrote in the final evaluation form: "this was the best experience of my life."

Not to brag, because this being a great internship is not about it being well-organised, fun, adventurous, insta-worthy.  The things that our summer interns reflected upon this weekend as they left were much more the hard ones. They were already en route when Uganda announced a lock-down, closing schools again and prohibiting movement between districts or even in a private car at all. COVID impacted us as it has the whole world; so this internship was not easy, but worth it.  As they head back to university, and we head back to normal days, here is really why even a couple of months of cross-cultural learning and service can disrupt life. In a good way. And I am going to frame them around a talk I heard by Bryan Stevenson (author of Just Mercy,  listen to a summary of the four points from him here. )




Seek proximity.
Until you remove yourself from the familiar and enter fully into a place that is unknown to you, until you live day in and out surrounded by some version of the same challenges that the majority world faces, it is quite difficult to authentically understand people, relate. So the pre-requisite is proximity. But proximity opens a door that you then can’t easily shut. Proximity means grappling with the unfair balances of the world—why do the kids living a stone’s throw from your door say they are hungry, seem so thirsty for attention, wear clothes that need repair, have no school or books, have to hustle for everything? Proximity, moves these questions from the theoretical to the urgent. Proximity is a prerequisite to human connection, and our interns this summer commented over and over that the experience shifted their focus from task to relationship.

Change the Narrative. Being proximal is the first step to seeing that the stories we thought were true might have nuance, might have plots that are different than we thought. When our interns helped in the NICU, and encountered young women their age with premature babies who were on the verge of death, they wanted to know these people and hear about their lives. Shoulder to shoulder one learns that a choice between pregnancy and university does not necessarily exist for most teens. That the cultural assurance in the wealthiest countries that hard work assures an easy life does not ring true when watching an old woman hoe potatoes. . . or when the young teachers who are helping with the COVID-Protocol-limited youth camps are actually available because schools are shut down, salaries cut off. A richer narrative of nuance pushes us to deeper Gospel analogies, perhaps giving the covenant and community sharper focus than courtrooms and law.

Accept discomfort. Our interns got tired. Very tired. They hiked hours to help with a remote water project. They wore suffocating masks in a humid crowded hospital room. They had an outdoor, separate toilet and cold shower. They walked to a lively outdoor market to obtain ingredients to cook for themselves and share with others, and had to negotiate as a group on clean up and varying opinions on schedules and boundaries. They were constantly in situations where they couldn’t understand the language, and they plodded along with rudimentary lessons in dialogue. They were constantly presented with needs they could not meet, problems they could not solve. They spent a day in a refugee camp with a very disorganised nutrition screening for hundreds of kids, and another loading trucks with heavy sacks of food and bouncing through the mud to remote corners of the district. They poured themselves  daily into kids, games, reading, sports, teaching for both team and neighbours. And they talked about the weight of complexity—how helping can hurt, how giving can be at times good and at times enabling, how the world looks less simple.

Hold onto hope. A two-month summer is a relatively short arc of story and experience. But they were part of a multi-decade arc in Bundibugyo, part of a multi-millennia arc of God’s work to restore the world. As they left they reflected on the signs of hope: following up patients discharged from the nutrition program and finding them healthy, hearing testimony from graduates of Christ School who came to faith and have meaningful work and family now, leading kids through summer camp programs that built their skills and connected them to God. They studied the Gospel-centered life together and reflected on their own faith. Several came through the summer feeling a sense of confirmation that this life, this work, this community, shone with the kind of meaning and potential for good that they wanted to be part of. 

Ann did make the experience well-organised, and our team did make it fun. There were pizza nights and game nights, hikes to waterfalls and mornings with cinnamon rolls and coffee. And we did end with an insta-worthy adventure, trekking chimpanzees in Kibale National Park. Because our model is Jesus, who came to be with us, who patiently used parables and miracles to challenge and change the narrative, who not only preached sacrifice but lived it on the cross, and who ended with resurrection and hope. And along the way, there were beach fish fries and evenings of feasting, weddings and mountaintops. Living with Jesus disrupts the neat life-plans then, and now. 












If you’re ready to risk it, applications open in September for summer 2022.


Monday, July 26, 2021

Where relief and development meet: A day with COVID relief packages in Bundibugyo

 If you have followed World Harvest Uganda, or Serge in Africa, for the coming-up-on-28 years we've been bearing testimony . . . you're aware that our vision is large and holistic, and our methods are long-term and slow. Christ School has been a 21 year marathon. We have teams with people finishing two and even into their third five-year terms, places where we don't just construct a hospital building but also train class after class of students and interns, or track malnourished kids over years, or plant churches that have gone on to plant other churches, teach pastors who go on to create other programs, disciple coaches who reach into slums and villages. Real understanding takes study, and that study can only happen by living alongside the language, the culture, the challenges, in real time. Real change takes trust, and trust requires relational capital that only grows with multi-year presence and investment.  In the NGO world, this is called "development"; in the Christian world it is called "incarnation". Jesus didn't beam in for a dramatic moment, he took on our bodies and walked our paths.


But sometimes, a response to a crisis means that we shift into "relief" mode.
A war sends people on the run into camps, and we might do immunisations or nutrition screening or supplements for kids. A landslide knocks down a swath of homes, and we might buy mattresses and cooking pots to get people back on their feet. Ebola or Covid shut down an area, and we might help fill a financial gap to sustain health centres. In the last few years in Bundibugyo, our spending is about 5% relief and 95% development, which is appropriate to our Kingdom purposes. Pushing on for the long term change that makes the community more resilient and capable of crisis response, but ready to respond to the overwhelming situations that arise. Jesus spent most days walking and talking with disciples, instilling a love-God love-neighbour ethos to change their ways and hearts. But the Gospels are full of dramatic miracles too. Not every blind person in the Palestinian area was remarkably healed or every hungry person fed in those years, but the ones who were pointed out the nature of the world to come, the reality we are made for and long for and press on to inhabit.

So . . . when we went to formally greet the new post-election District government this month, both the LC5 (locally elected governor) and the RDC (centrally appointed representative) asked us to respond to the economic distress of the COVID lockdown in our District. They noted that we had provided quick immediate help when Congolese refugees started filling our local transit centre, so reasoned we should also help our Ugandan neighbours (equality is a very very very strong value). We can't do anything meaningful for 260,000 people, but they proposed a list of registered community groups for the vulnerable, and we agreed to fund a small relief package for one group of up to 30 families per sub-county and township. That's 25 x 30 or 750 families, scattered across the whole district. Some were widows' groups, some disabled, some the unemployed boda drivers (as I saw in a political cartoon, the boda (motorcycle taxi) driver is an essential worker both for most of the health care and commerce in this country but also for providing for his own children), some people living with HIV/AIDS. With the government's leave to transport and gather small groups under COVID protocols, we could proceed in a time where churches, schools, and even driving are prohibited. 

Thanks to donors, even a last-minute two churches who spontaneously wrote and asked how they could help in this COVID time, with the balance of what was raised last year for floods and not fully spent on refugees . . we came up with a budget of about 100,000 USH per family ($28) to purchase, transport, and distribute a 25-kg (55 pound) sack of rice, a 5-kg (11 pounds) sack of beans, 1-kg (2 pounds) of salt, and a crisp 5,000 USH note to help as needed (hauling the goods home on a motorcycle boda, or buying cooking oil or firewood). Over the weekend our administrator John Balitebia supervised the purchase and importation of this food while sending out trusted mission colleagues (Christ School grads who stay active as alumni) to verify each group and prepare them, and yesterday his team of 5 trucks, each with a trained crew of distributors, reached every corner of this district. 

This entire exercise was beautiful on so many levels. First, it was an open door to show God's love sprinkled into hard-to-reach places with word and deed. These recipients were just a sample of the people on the margins rarely tallied in COVID impacts, who have found the austerity of this time to be a heavy burden. Each distributing team shared a short message to the waiting crowd. I listened to one, and the "preacher" was a former CSB student from a different religious background, an orphan, who met Jesus through the discipleship of the school, and gave his own testimony while pointing out that God is a God of seeing and presence, who reaches into the resources of people far away to recognise those who are suffering, and has brought them this food. So the whole thing was a lovely picture of the Gospel right there. 






But secondly, as we have done this a handful of times over the last few years, our World Harvest Uganda team has become quite trustworthy and efficient.
John is competent with a spreadsheet and a plan, and others who are mostly all CSB alumni know how to mobilise in the community, check the facts, arrange the trucks, control the crowd, preach and distribute. We instigate and observe basically, while the young generation who were toddlers when we came, who grew up with our kids, who played and learned math facts and Bible stories in our yard and around the mission, who came to Christ School, whom the teaching staff invested in with skills and personal discipleship, whom many have helped with scholarships . . . do the work. And do it well. 


So in the end, relief and development meet.
The long arc of decades of development means that the relief work can be done by local people who know the villages, speak the language, and have the capacity and integrity to carry on with the service.

We pray that the rice and beans fill hungry stomachs, and the experience of hearing and seeing God's love fills tired souls. We are all tired of this pandemic. But that doesn't matter, troubles don't end when we're tired of them. God asks us to stay in the fray, to keep at the margins with service and stamina. Thanks to donors who in their own weariness see that the suffering, like the vaccines and oxygen supply, is not justly spread over the world. Some pockets are harder than others. Thanks.

If you would like to contribute to the Uganda Emergency Relief Fund--CLICK HERE