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Friday, May 30, 2008

Deadly Ideas

Ideas can kill, and last night one did.  Asaba, a 6 month old, was slain by a deadly belief.  

He was admitted to the hospital in mid-May with a diagnosis of malnutrition.  When I came back this week I found that in spite of being provided with milk and medicine, he had steadily dwindled, until he was barely over 4 kg (9 pounds), a skin-covered skeleton, all eyes and ribs.  His mother reported that he had continuous diarrhea, so we kept trying treatments, rehydration solution, feedings, checking labs.  By Wednesday, my third day to see him, I was alarmed enough to begin empiric TB therapy, thinking we did not have much time left.  Thursday, he had dwindled even further.   Then I counted his pills and milk packets and made a startling realization:  every medicine and most of the milk he had been dispensed was still there, unused.  We pleaded with her to take the situation seriously and give the treatments.  Finally she confessed to one of the nurses that the baby suffered from bhibabuli, internal wounds caused by a spiritual curse.  She believed that in this case the pills would possibly kill him, so she had not given any.  In fact she was using the local remedy for this syndrome:  herbal enemas, administered by gourds or hollow stems, concoctions blown into the baby’s intestines by his mother.  She came to stay in the hospital so that the baby’s spirit would not be angry with her, since if he died at home he might come back to disturb the family who had not pursued every option for care, but though she was occupying a bed she wanted nothing to do with our treatments.

I sympathized with her, knowing that she was merely doing what she thought would save her child’s life, knowing that she feared a malicious relative or neighbor had caused this problem by poisoning her breast milk using secret charms buried in a path that she had inadvertently walked over.  But I pleaded with her to believe that her remedies (withholding feeds and administering enemas) were actually killing him.  I called a meeting of all the patients and caretakers and argued with some passion.  They can make poultices and apply herbs and charms all they want, I said, but when I see babies’ gums being sliced open to remove “false teeth” or babies’ being dehydrated and starved to death by enemas, I can not keep silent.  On these two issues, I drew the line.

What is interesting about these two beliefs, the bhino (false teeth) and bhibabuli (intestinal wounds), is that they are recent additions to the culture.  They are not ancient traditions.  The bhino idea came into Bundibugyo in the 70’s with Idi Amin’s soldiers who hailed from northern tribes.  And the bhibabuli theory has just surfaced in the last two years, seeping over the border from the depths of the Ituri rain forest in Congo, gaining adherents month by month.  In a place where children die regularly, people are looking for answers.  And if herbalists/witch doctors/traditional healers can make serious money off of procedures and treatments, then the belief will be perpetuated.  

This is the real battlefront, and we need prayer to appropriately engage and fight against deadly ideas without blaming the victims or hardening into self-righteousness smugness.  Pray that we could be graceful warriors, the kind who find a child’s life an issue worth fighting over, but in a way that does not mow down the people we are called to help.

The other death in the hospital this week was a teenage girl who died of septic shock after a self-induced abortion.  More deadly ideas:  that a wire can solve her problems, that shame or fear prevents telling the truth and getting help, that the fetus’ life was inconsequential, that her life would be guaranteed.  

It is sad enough to mourn death from incurable diseases, but sadder still to consider these two lives lost needlessly to the power of false ideas.

Wednesday, May 28, 2008

On witness

To be a witness does not consist in engaging in propaganda, nor even in stirring people up, but in being a living mystery.  It means to live in such a way that one’s life would not make sense if God did not exist.
--Emmanual Cardinal Suhard

This quote came in some of my reading over the sabbatical, and strikes me as a worthy goal for our missionary life here—to live so that our lives only make sense in light of the reality of God.  Amen.

Sorrow in the WHM family

This week our WHM community received difficult news:  Nancy Macha, missionary to Ireland, discipler and friend to many, wife of the head of mobilization for the mission, was told that the breast cancer she had hoped had been cured by surgery and chemotherapy over the last six months, had instead metastasized.  It is aggressive and serious and in human terms fatal.  Her husband, three children, and grandchildren have gathered, and hundreds and hundreds of people all over this world who have seen Jesus in Nancy are now praying for her, for mercy, for miracles, for courage, for relief.  Please join us.  You can follow the Macha’s journey here:

On resurrections, cause, effect, and return to reality

Our friend Maria Garriott’s book title, A Thousand Resurrections, comes to my mind often, particularly these first few days back (it is excellent reading on the Kingdom in inner city Baltimore. . .).  All around us, if we have eyes to see, the often subtle and occasionally dramatic reversal of death.  Birungi Suizen, 9.2 kg, twice as much of him to love as a few months ago, came back for follow-up yesterday, watching my pocket for the expected candy to appear, a bit hesitant after a month but not afraid.  His mother had a wide smile.  Was it the UNICEF milk, the TB meds, the prayers, the hands-on care of the staff, the temporary removal from a disorganized home situation?  Or all of that?  It is no less a resurrection if God uses the molecules in a pill or a packet of milk than if He works in unseen ways.  We sometimes assume the thin veneer of cause and effect that we can measure explains the world, which is a blindly arrogant assumption.  So I rejoice in Birungi’s life and in the multitude of ways he was healed.  And I affirm that God takes pleasure in his resurrection, just because he is a child, not because of any noble or useful thing he will eventually do.

And Birungi is not alone.  Today Musoki Irene and Mumbere both came for follow-up.  Both were giggling, with smoother skin and energy revived by their ARV’s, both had been pulled back from the precipice of death by their grandmothers’ care, by medicine and food and love and miracle.  And Kabasa, the “little boss”, showed up with his negative PCR results, rescued from infection by medicine and early weaning and good counsel and a committed mother.  Robbinah, whom I left as a wasted wisp of a baby, came to greet me and I did not recognize her new fleshed-out face, even though I had prayed for her daily on the break!  Amazing.  

These resurrections then balance the reality of return.  A month away from Bundibugyo means that every kid we sponsor (or that old team mates sponsor) needs fees and supplies, every patient that we’ve referred for care outside the district needs transportation money for follow-up, every patient that was referred to us over those weeks now takes their opportunity to come for care, and the ever growing number of people who consider themselves our friends feel free to come and explain their most recent crises and needs.  Return is brutal, and Scott takes the brunt of it, but we all feel the onslaught.  

In a few months, perhaps the frail babies admitted today will also be resurrection stories.  Two British agriculture/veterinary missionary couples are visiting this week to support Karen’s Matiti project, and when I feel fed up with the filth and darkness of Bundibugyo it helps my heart to hear them affirm that our people take excellent care of their goats, and to see their excitement about the way these animals can be part of the resurrections to come, feeding the motherless, rescuing the infected.

So we press on, counting the resurrections, hoping for a thousand.

Sunday, May 25, 2008

Back to the Land of Paradox

Today we mourned a death and celebrated a survival.

Our neighbor John Mukidde died last Monday while we were still in Zanzibar. He had suffered terribly over the last year and we can hardly believe he made it to May, but we had still hoped to be there for his burial. He was a loyal and gracious fatherly presence for us over the last 14 years, someone who took the risk and effort to befriend many of us missionaries, and particularly our family. As soon as we pulled into our driveway I went over to see his family, and both wives broke down sobbing when they saw me, so we all sat and cried together, a few hugs and murmured greetings but mostly tears and silence. This morning we paid a more official visit with the whole family, praying again by the fresh grave. His mostly-absent, former-rebel-turned-politically-savvy-entrepreneur son was granted ownership of the home and responsibility for the family, which includes his two wives and three minor children. We already help with school fees for two of the kids, and I’m sure will continue to be in their lives, but we will miss Mukidde very very much.

In the afternoon, in contrast, we were invited to a party. The Bataama clan had decided to throw a major event in celebration of the survival of one of their own, a nurse named Peluci Tabita, who contracted Ebola last December but lived to recover. It was an unprecedented category of event, but we were later told it was modeled on a post-circumcision clan gathering, with the same music and dances and honoring of the survivors and presentation of gifts, and with the intent of preserving by adapting some “Kibwisi” culture. Easily 400 people attended, maybe more, seated under three tented canopies in the compound of neighbors a short distance up the road in Bundikakemba. The party began with a procession as Peluci and one other survivor were led by dancing women waving coffee branches and men beating drums. Then a group of about a dozen very energetic male dancers stomped their belled feet and blew their flutes (each with a tuft of colobus monkey fur on the end), and shook their hips accentuated by waving grass skirts, sang and danced until the dust rose in clouds, all while three men beat on a half-dozen drums with syncopation and wild power. Of course there were speeches, too. Scott was on the program, and used his opportunity to preach to the huge crowd. He acted out the story of the one thankful leper (Luke 17), relating it to this celebration, giving thanks to God which we so often fail to do once the danger has passed. But he also talked about joy and sorrow being the two sides of the same coin. He challenged people to think about God, and did not give simplistic answers to the question of why some health workers died and others like this nurse survived. And he shared again the passage from John 12 that he read at Jonah’s burial, and talked about the seed dying to produce fruit. His care for people during Ebola has really opened doors in their hearts, how often do any of us as missionaries get to preach to hundreds of people? We are not pastors but doctors; yet the very doctoring means that this clan listened to Scott. When it came time for the reception, where people congratulated the two survivors by bringing gifts, they asked Scott to sit beside them, as the circumciser (a traditional doctor) would have done in the ceremony. He was a bit reluctant, but went along with it . . .and then really surprised when after the two survivors were given goats, he was also given one! Peluci and the other man received many other gifts as well, and waves of people came forward to shake hands with all three. At the very end the deputy RDC stood up and thanked Scott for standing by the district in the time of need, saying that it was God’s heart they saw in him. We thought we were dropping by to be polite, but we ended up spending the afternoon embraced by a culture very different from ours but which claims us more and more, and walking home with our own little goat tugging at her twine rope and bleating “maaaa”. We felt rather conspicuous, but here dragging a goat down the road is very normal, and as people greeted on the street they barely gave the animal a second look. DMC and SirLoin, our two cows, were not too friendly to this addition to their pasture, but we hope they will all get along.

So we have not unpacked really, except food for survival, our house is stacked with trunks and books and dirty clothes. But we know we are back to our Bundibugyo home where extreme paradox is part of the daily reality, where we can cry with one neighbor and dance with another a few hours and a few hundred meters apart.

Wednesday, May 21, 2008

Washed back to shore

At 1 am this morning we washed back onto the shore of Uganda, after three weeks at sea.  

For three weeks of sabbatical we breathed and ate and slept and read and talked and played and thought and prayed, in short we practiced the difficult and nearly lost art of just being, in the presence of God and our family, with no agenda to accomplish.  Not even a spiritual agenda:  yes, we prayed, but after sleeping long and well, and even the prayers were not directed at a particular decision or outcome.  By grace we found ourselves in a simple but beautiful villa, an open-to-the-breeze house with a high grass roof and wide shaded veranda overlooking a sheltered cove of the Indian Ocean, on the east coast of the island of Zanzibar.  No TV, no phone, no restaurants or places to go or visit, no stores within an hour's drive, no organized activities, no pool, no A/C, no one who speaks more than a phrase of English, no one who knows us or expects anything from us.  Just blazing sun, the rhythm of the tides, stacks of good books, fresh seafood, and meters and meters of open sand and open water.  Most mornings we awoke to a minute-by-minute crescendo of sunrise colors, read and prayed on the porch before the kids got up.  Breakfast, swim in the ocean, games, reading, more swimming.  Our family collectively read more than a hundred books, a bit of an orgy in words and thoughts I realize, but wonderful.  In three weeks we only got into a taxi once to visit the historic capital Stone Town, otherwise we stayed on the beach.  There was a fishing village nearby, so we were not completely removed from life, as scores of dhows sailed in and out of the lagoon filled with men going to fish in the deeper waters while younger men and children hunted fish with spears in the shallow lagoon and women gathered armfuls of seaweed.  This was supposed to be rainy season, so we saw only a half-dozen other foreigners the entire time we were there, many of the island's hotels being closed for the month.  I can envision one of our prayer-warrior supporters like Aaron holding up Moses' hands and swaying the battle--someone must have prayed for the storms of May to desist from the island, because we barely saw a cloud until the last few days.  We learned that our kids can (mostly) just "be" too, they loved the quiet, the water, the huge pillowed couches for reading, the relaxed attention from their parents, the rounds and rounds of games of hearts and speed scrabble, the never-the-same entertainment of the lagoon's corrals.  By far the best aspect of this house was that we could walk off the porch and directly into the ocean, and depending on the tide wade or swim amongst branching corrals and darting bright tropical fish.  The lagoon was sheltered by an off-shore reef, which swam out to almost daily.  There the waves crashed with exhilarating power, and beyond the breakers we could snorkel over wild patterns of corral and schools of fish.

And God was there.  We met Him in the quiet, and in the sudden rain squalls.  In the endlessness of the ocean, it's mighty power of tide and force.  In the hiddenness of the water's depths.  In the danger of being crushed or lost in the waves.  In the beauty of the extravagance of species, the vivid improbable colors, the endless variations of shapes.  In the certainty of the tide's ebb and flow.  In the obscurity, the way the complicated balance of the underwater gardens can not be imagined from the surface, but must be seen through masks under the water.  It reminded me of the veil that masks spiritual reality to our naked eyes most of the time, we lack the mask or goggles to glimpse the flurry of angelic presence that is truly there.  

In spite of all this wonder and beauty, Zanzibar is an island that has hosted some of the worst evils of human-kind, as a key harbor and market in the slave trade.  It is still a place where most are poor, where there is suspicion of the foreign, where the organized religion of the vast majority resists change.  Our one day of historic exploration took us down into cramped cellar vaults in Stone Town where Africans were held to be auctioned at the slave market, and to a moving statue and cathedral dedicated to the memory of the abolition of the trade.  When we organize the pictures I will try to post the plaque that recognizes the work of David Livingstone, because it quoted from my favorite verses in Rev 12, in a poignant way.  We were in Zanzibar in response to the suffering of Africa that had sapped our souls this year, to recover from Ebola and Jonah's death and the draining fear of risking more great loss.  The sun and wind and water and peace brought great healing, but I'm glad that in the middle of that we also got a glimpse of the tremendous courage and faith that forged these paths long ago, the company of the saints.

I miss the surf, the moving sound of the tide.  We had our respite of bathing in the depths of God's barely-skimmed oceanic presence, and now he has washed us back ashore.  But in coming back to Uganda we come home, thankful for the familiarity and friendliness.  And we washed right back into our community of saints, meeting most of our team here in Kampala, for which I am thankful.  One of the many passages that stood out in the last month was the book of Jonah--both for the linguistic connection with our friend Jonah, and in the strong themes of watery depths and God's deliverance, of wondering if God's call is too hard and too much, of drawing away, of God's pursuit, and mercy.  So now being washed back to shore we pray that we will take the road to Niniveh and live boldly and truly in that place.