The Best Thanksgiving Rodeo Ever

Tonight we go to bed tired but full, not only of food but also of the blessing of community. From the dramatic sacrifice of the turkey this morning (spouting blood, wings firmly held down by the scalpel- wielding Scott) to the last hour of the late night, sitting out on our brick patio by candlelight guffawing over Heidi's acting and Nathan's chagrin as we played "basket of nouns", it was a day to remember. Hospital rounds were as quick as I could make them (this is after all NOT a Ugandan holiday) and then the rest of the day was devoted to cooking and cleaning. The clan gathered at 4, all 29 of us, team and visitors reciting a Psalm of Thanksgiving responsively (136) and then delving into the feast. It is truly amazing what creative and motivated people can come up with in the way of American traditional cooking in Africa: apple pies to mashed potatoes and gravy, we had it all. Barb decided to inject some Texas culture into our mix, and with barely an hour of digestion we were out in the yard as the sun sank into pink, for sack races, an egg toss, tug of war, even a game to capture the flag of a bandana tied to a real live goat. A couple of Ugandan friends stopped in and got drawn into the fun, and dozens others were quite entertained from the path I'm sure. Then dessert, the first official Christmas movie of the season (Charlie Brown Christmas), a short goodbye and thanks to the Ryans, some washing up and at last the game. I am thankful for our team today.

Thanksgiving

The original Thanksgiving was a raw sigh of relief, an acknowledgment of survival, and a tribute to the cross-cultural relationships that made it possible. Amen.  Like the pilgrims, we can look back on this year and soberly reflect that survival was not a given.  We can remember the colleagues that have fallen at our side, some to death like Dr. Jonah, others to illness, attrition, weariness, and changing life plans. But also like the pilgrims, we can say that, by God's enduring mercy and unfathomable disparity of action, here we are a year later, even though some others are not.

 Last night the Pierces hosted a party in their yard, the entire staff Christ School and our team circled in the lantern-light to give tribute to the year gone by, and to say goodbye to Madame Betty, deputy headmaster and faithful teacher for the last 5 years.  There were skits and speeches and the requisite food, starlight and cake and an ending song of praise.  Today we will have a more American Thanksgiving dinner at our house, the live turkey a few hours ago causing a ruckus being chased by the dog who was being chased by the kids who were being chased by me . . . I am struck by the way that feasting occurs right on the edge of death, by the courage of the pilgrims to initiate a banquet having so closely averted famine.  Sharing food and wine and fellowship in a place where disaster hovers . . .that seems to be in the spirit of Thanksgiving.  And in the spirit of the Lord's supper, the intermingling of eating and drinking with the impending reality of death and sacrifice.  So today will be another poignant milestone.  Two years ago the Pierces were brand new to our team, and Dr. Jonah ate Thanksgiving dinner with all of us in their home, he had not yet moved his family back out to Bundibugyo.  I remember him seated by Julia, participating in the game of telephone we played with messages around the table, laughing.  Last year we were aware of the mystery disease, but the announcement of ebola was still a week away.  This year we have much to be thankful for, perhaps even moreso because of our awareness of the nearness of that line between survival and sadness. Give thanks to the Lord, for his mercy endures forever.   And nothing else really does.

Through the river and through the woods...

Sunday morning Skip and I (Scott) mounted our trusty steed (Honda 200 XL) and hit the dusty trail.  Ten kilometers of weaving between mud holes and even fording a small stream.  To do that we shared the one pair of boots that I wore -- first Skip traversed the stream and then threw the boots back across the stream so I could use them to push the motorcycle through!

We trekked to Bundikyora New Life Church, the last stop in Skip's Sunday Sermon Series.  The small mud-walled, tin-roofed building held a capacity crowd who came to swivel and sing, twist and shout in praise of God.  At one point in the service the entire sanctuary was one big cloud of dust from all of the  gyrations and jumping.  Skip (who has written a book entitled Worship) said he had never experienced more joyous worship.

Skip preached from Matthew 4 on The Temptations of Jesus.  He tied in the Temptations of Eve from Genesis 3 and helped people to see that the temptations were basically the same...the lust of the eyes (we want what we see) and pride (we want to control our own lives, to be our own gods).   Finally, he exhorted us to see that Jesus is the only One who has ever successfully resisted temptation and we need to receive his success as our own by faith.

Afterwards we were seated in a small dank mud house where we ate a lunch of heaping plates of rice and beef.  We were left by our hosts to eat alone, surrounded by dog-eared  posters entitled  "Queen Elizabeth's visit to Uganda",  "Manchester United Football 2009" and "The last days of Saddam Hussein".  After a post-lunch debrief with the church leaders of all the challenges before them in leading and growing their small body of believers we headed home.  

As Skip dismounted the motorcycle upon arrival he said, "Now that we're home, I can admit that that ride was the scariest part of my Ugandan adventure so far..."

Our bizarre life

While we were welcoming Karen and the kids (see below) Scott was
attending to two Members of Parliament, who were making a tour of
Western Uganda and had selected Nyahuka Health Center as one of their
stops. The Honorable Jane, who as Bundibugyo's MP has been a strong
advocate for us and for CSB over the years, accompanied the Honorable
Christopher, who represents Kasese now, though he was born locally,
and is the brother of the King of the Bakonjo. So in one of the
bizarre twists of our normal life, Scott found himself called upon to
tour them around and then make a speech. He's good at that kind of
spontaneous problem-presentation, narrowing down to a few concrete
points which the politicians might actually be able to address:
change the formula for health center funding from catchment area
(geography) to patient volume (population), which would then give NHC
75% to 80% of the level of funds given Bundibugyo hospital, instead of
5%. And streamline the district service commission, which Scott
boldly identified as an epicenter of corruption and inefficiency. In
response, he got to sit in the public meeting and hear the Honorable
Jane tell everyone that it was "a miracle Dr. Scott is even alive" in
reference to our ebola experiences, and commend him for his work in
Bundibugyo over the years. Politics, yes, but also I think God often
sends these encouragements out of the blue when we shake our heads at
our problems and wonder if we're in the right place.

I thought I had dodged the whole hooplah, but as I walked into my yard
from Karen's welcome party the official vehicle carrying the MP's
pulled in behind me. They had decided to pay a personal visit to our
home, so we sat and chatted some more about ensuring Melen received
Dr. Jonah's workman's compensation, while they drank cold sodas.
Scott gave everyone Kwejuna Project t-shirts, and even sent one for
President Museveni to whom they will report the findings of their
visit on Monday.

We can be dressing the wounds of a widow, feeding an orphan, and
greeting a parliamentarian, all in the same hour, all in the same
space. Bizarre.

Reunions

In a life that contains way too many goodbyes, the reunions stand out, sweet and strong.  I can see now Julia hugging Acacia when she left, and when she returned yesterday.  Karen and kids touched down about noon on the airstrip, enveloped immediately into the community that has missed them.  Naomi and Quinn almost popped in the moments of anticipation, and the friends have been inseparable since.  Karen told us all the story of their first two weeks, with photos.  I think my favorite part was the way the airplane pilot making a landing mid-stay just "happened" to bring them a load of fresh vegetables, right when they had reached a low point of feeling desperate about the lack of food choices.  I remember only vaguely now the way Uganda was in the early 90's, the sense of burden in collecting and cooking enough calories to sustain a family, but this challenge looms large for Karen.  The diocese of Mundri has welcomed them warmly, and we rejoice to hear their opportunities and dreams.  Last night, we had the fun privilege of hosting ALL the team kids for dinner, and movies and cake.  A taste of the final feast of the Lamb, the reunion of all reunions.  

Ebola in the News

Just in time for the one-year anniversary of Ebola, the open-access Public Library of Science journal on-line has published research that arose from our outbreak.  Here are two clips from news reports today:

From Science News:

A species of Ebola virus that emerged in Uganda in November 2007 is unlike any other, scientists report in the November PLoS Pathogens. A team of U.S. and Ugandan researchers collected and analyzed blood samples from people infected in and around the town of Bundibugyo and found that last year's outbreak of hemorrhagic fever there resulted from a previously unknown Ebola species, tentatively called Bundibugyo ebolavirus. The virus infected roughly 100 people, of whom 37 died, says virologist Jonathan Towner of the Centers for Disease Control and Prevention in Atlanta.

From AFP:  

The newly-discovered species came to light after VHF erupted in the townships of Bundibugyo and Kikyo in November 2007, says the study, authored by US and Ugandan doctors.

The US Centers for Disease Control and Prevention (CDC) tested 29 blood samples, which were negative to high-sensitivity tests tailored to the three known strains of Ebola virus. But the samples tested positive in an older, broad-spectrum antibody assay. Intrigued, investigators pulled apart the pathogen's genetic code to see what they had snared.  Using ultra-fast sequencing technology, they decoded the virus' genome in a matter of days, finding a variation of 32 percent compared with the three existing strains.  Of the 149 suspected cases of Bundibugyo ebolavirus, 37 were fatal, translating into a mortality rate of 36 percent.

The wide genetic divergence between the strains has major implications, the authors say.  It will require the invention of new diagnostic tools to detect outbreaks and could complicate the quest for vaccines and treatments.

So as the hot winds of drier season blow us into December, and my kids begin playing Christmas carols, I find my heart and thoughts harking back to the events of last November.  It was a year ago next week that we went to Kikyo and saw patients ourselves, and days later that the outbreak was confirmed to be Ebola.  Christmas and death have become inextricably intertwined.

Kwejuna Day

Yesterday the quarterly distribution of supplemental food (20 kg ofbeans, 3 liters of oil, a kilo of salt) drew a record 230 HIV-infected women to the WHM Community Center. Most had a baby or relative in tow, so imagine the chaos of about 500 people milling through our various stations, reuniting with friends, comparing experiences and admiring each other's babies. Each is interviewed first by a health worker or peer educator, to document her status and be sure she is enrolled in ongoing care and treatment. Each is weighed and measured, to collect data on nutritional status. We scrutinize the outcome measures for the babies, and have a temporary lab set up for either sending blood spot samples for viral testing or immediate antibody screening. Each woman is offered family planning on the spot, too.

Most  importantly, all have the opportunity to enter a side room in small groups for prayer. Skip and Barb poured out their hearts to woman after woman, hearing their worries, lending a compassionate ear, laying on hands and praying. Theses women carry heavy burdens of rejection by their families, abuse in their marriages, anxiety about who will care for their children when they die, weakness as they deal with their own declining health. Being heard, and being interceded for before God . . . these are gifts that the Ryans and Pastor Kisembo offered.

Finally there was a message to all: a sack of beans and a cup of oil given to the dying, God's miraculous provision to the widow that aided Elijah reflected in the present reality, a gift that can multiply into grace for many. Each woman was then called forward to receive the food, and a generous "transport" allowance (cash) to get it all home.

A LONG day, person after person, so much brokeness. Yet these are always celebratory days too, giving good-news test results to most, seeing growth and survival. And witnessing the partnership of a former team mate who advocates, a generous supporting couple who finances, nearly our entire team at work, a dozen health workers who give their all. We are grateful.

By any road

The over-night trip to Semliki Safari Lodge was, as in past years, exactly what we needed. Peace and privacy, sun and a small pool, the raucous sounds of monkeys in the trees outside our spacious tent in the night, morning birds and coffee on the porch, long talks,excellent food presented in civility. And this year the treat of going with Skip and Barb Ryan. Who would have believed that thesepeople who seemed a short step down from deity when we were in college 25 years ago would now be spending a retreat sharing focused attention, love, concern, and prayer . . . would now be our friends?Amazing.

The trip home, as it often does, threatened to thoroughly erase the restoration of the almost two days away. All was well until the very top of the mountain switchbacks, when our right rear tire blew out.  Scott got the truck to the side of the precarious road and jacked up in a few short minutes, he's had so much practice. Then we found outthat not one, but BOTH of our spare tires were flat. These were tires that had been repaired, one in Kampala at the premier tire centre, but inexplicably over the journey on the roof rack had lost their air.

Even for us this was a new situation: six tires, only three usable, so stuck. It was not long before the first truck stopped and let Scott add on to the mountain of matoke and clutching passengers, with the two spares, to the nearest village (about a half-hour away). Meanwhile the Ryans and I sat on the tailgate reading books in the dusk of the deserted mountain road, until Pat and Nathan came along, also returning to Bundibugyo from an EGPAF meeting in Kampala. To make a very long (HOURS) story shorter, Barb and I ended up getting a ride home with Pat, in the dark but at least in time to get my kids from the Pierces and to bed. Nathan and Skip waited for Scott to bring a spare back by motorcycle in the dark, discover that our new jack was not functional, wait for another good samaritan to lend a second jack, change the tire, have it go flat again, get a the second spare on, have the car fail to start, finally get it started, have the second spare begin to leak air, and at last have the angelic driver of the good samaritan truck wedge a pebble between the tire's tube stem and wheel rim that maintained enough air to carry them home at about 10 pm.

This morning I read this quote" The Lord is glorified in a people whose heart is set at any cost, by any road, upon the goal which is God himself. A man who is thus minded says, 'By any road!' Amen, but our road has quite a few bumps, jolts, mires, and treachery. And flat tires, dust and delays. Praying we can stay on track.

rest and small things

Rest: I am profoundly in need of it. Scott too. For the last several years we've taken a night away in November, ostensibly for Scott's birthday, to the luxury tented safari camp inexplicably located only two or so hours from our home. It grew out of a friendship with the managers, and has become a lifeline which we could not otherwise afford but desperately need. So readers-who-are-pray-ers can ask that the next 36 hours be a time of focus inward, a freedom from the every-ten-minute demand and crisis of normal life, a refreshment of beauty, quiet, sleep, and soul-connection. And pray that we make it through this day to reach our rest! Today I found 43 inpatients on the 25 bed ward, in other words an insane and exhausting crush of sickness and sadness. Plus two phone calls in the midst of rounds, one from Mulago and one from Mbale, were I have sent patients, whose needs still reach me. Near the end I came to little Mbabazi Kristine, whose mother has remained cheerful throughout more than a month of struggle over her dwindling life. Not so today, today her tears began to flow, and she asked to go home. Heidi had the good idea of introducing her to her across-the aisle neighbor who once looked the same and had the same diagnoses, but is now a solid chunk of a boy. I don't know if she was convinced to persevere, but I begged her to stay. Slogging through all this and trying to think clearly and compassionately in two languages pretty much wears me out, some days more than others, and this was one of them. Add to that concern for team mates and their hearts, treading fine lines that I fail to navigate well that require listening and supporting without fixing and answering, absorbing the angst of four kids entering exam periods, embracing my limited-ness and living in the hands of an all- powerful God . . . well, I'm ready for a break. and hoping that no sudden illness or disaster keeps us from it.

Small things: we had an extended prayer time last night, for the coming Day of the Lord in Bundibugyo, a time of repentance and vision for God's purposes . . . based on the book of Zechariah. In preparation I have been reading and re-reading the book, full of fantastic visions and poetic truths. It was not until prayer time, though, that the phrase jumped out of chapter 4: "For who has despised the day of small things?" This comes right after "Not by might nor by power, but by My Spirit, says the LORD of hosts." Rather incongruous, God of the angel armies in His power commending us to notice the small things. So today I offer a brief testimony to a few small things, mostly because in my tiredness I need to remember the fragility of redemption's visible presence in the muck of now. The best: Fransini smiled. Again. This baby was essentially dead last week, a tiny bit of orphan with a dedicated grandmother who was gasping with pneumonia so distressedly that we resurrected a long- disused generator to get power to the old oxygen concentrator . . . and now he's smiling. And we're matchmaking him to his six-month-old wisp of a female counterpart, Malyamu, who dipped down into the realms of death last week too, but has now revived. Both just reached 4 kg milestones (a 25% improvement on their descent to the 3ish range), and both smiled at us, little human eyes looking for interaction in spite of their hungry suffering. 

One more anecdote...this afternoon, I dropped in on a nutrition seminar completely organized and executed by our three extension workers, a small group in the grand scheme of addressing world hunger . . .but 26 community members, men and women, young and old, had gathered to discuss team work and community development, chicken eggs and sustainability.  And best of all, we merely encouraged and observed, it was Lemech’s vision.  

Fransini and Malyamu, the prayers of a team mate, the pink clouds at dawn this morning, my kids who selflessly encourage us to go for this jaunt of a vacation without them, a bite of bread an sip of wine that partake of the reality of Jesus, these small things I do not despise.

About Blogging

During tonight's phone conversation with Luke he said, " You need to update your blog, it's pitiful" (meaning he's missing home and he wants news and photos). Caleb's reply from a poster he saw on-line (using his usual filing-cabinet brain to retrieve an appropriate quip):

Blogging . . never have so many with so little to say

said so much to so few.

Ah, out of the mouth of babes.