The Party's Over

For a few days we rode the crest (Bdays, good decisions, hopeful connections, healed patients) but we’ve now been thrown back against the unyielding rocks of reality. Death.  Yesterday morning as Heidi was weighing patients before rounds, and I was evaluating a dehydrated baby an off-duty nurse had pulled me aside to see, a family burst into the ward with their semi-conscious 6 year old son.  He began to vomit a putrid blood-tinged bile, and pass foul bloody stool.  Within a minute we had cleared out the treatment room, gotten gloves and IV supplies, and Heidi and the other nurse began to work on IV access.  The family gave a story of a grandmother who had just died, then this boy became suddenly ill the day before with headache and fever, and even blood in his urine.  A year ago I would not have been as concerned, but post-Ebola our awareness of the nearness of disaster has been forever heightened.  And our staff acted quickly, carefully drawing lab work, preparing the isolation ward (which has been closed for months), treating the patient’s symptoms.  When the malaria smear, sickle cell test, and other labs all came back negative we knew that the sudden onset and hemorrhagic symptoms warranted reporting the case and sending samples.  Sadly the child died about an hour after he arrived.  So the rest of the morning we had edgy staff, tangles of phone calls, a loudly wailing mother, and the  sad task of decontamination and bagging this small body.  The chances that this case will turn out to be anything worrisome are very, very remote:  his age, his location far from the other cases in the past all suggest that we were merely seeing the agonal last hour of a more common disease.  But I found the whole process profoundly tiring, dredging up the memories of the uncertain days of last December.   I found out that Heidi is made of strong stuff, calm in crisis.  I found out that once I got people on the phone, the mention of “bleeding” and “died” and “Bundibugyo” in the same sentence gets action.  Within two hours a blood and skin sample were delivered to the district for forwarding by the surveillance officer to the lab at the Uganda Viral Research Institute in Entebbe.  Results will take a week.   Discouragment.  Our youngest is struggling.  He was sick more than a week ago with an impressive rash, and now feels profoundly tired and sad, sort of a post-viral blueness exacerbated by the you-don’t-belong nature of his stressful school life, the spiritually dangerous nature of this place, anticipated grief in changes in the family as Luke moves towards boarding school, and mostly by his own discouragement that his calcaneal apophysitis (the heel problem) has still not fully healed.  I am used to a clash of wills.  I am not used to a heart-wrenching helplessness of a sobbing child.   Depletion.  CSB has its daily draining needs, 99% of which fall upon the Pierces, but as their team leaders and friends we ache here too.  Income (student tuition) has NEVER (since the inception of the school) covered Expenses (primarily Teacher Salaries and Student Meals).  This gap has been growing and now looms menacingly. Then this week they analyzed the food allocation more closely, and realized that as the numbers of students had expanded over recent years the protein provided in the diet had not kept pace.  When David saw that they were getting less than 20 grams of protein a day (instead of a good adolescent minimum of 50) he doubled the purchasing of beans and ground nuts.  An appropriate move, but a move based on faith and not on money in the bank.  Many schools in Uganda have been hard hit by the escalating food prices, and a season of relative drought.  We are not exempted.  Almost every day there is another challenge, and the ever-present background of debt makes each one more difficult. Demands.  One of our team Bible study questions this week was : Where are you, and where does God want to take you?  I had an image of treading water.  There is an occasional crest of wave when prayers are answered, when vision clears, when the ride is exhilarating.  But mostly I’m down in the valleys between the waves, pumping and paddling to merely stay afloat.  Progress is elusive.  Every hour of every day brings another needy person or undone deed.  The demands of life in Bundibugyo are endless.  Taking the time to advocate in Kampala and to spend on a fun activity last week means that this week I feel even further behind than usual.   But this morning in Psalm 88 I read:  “You have afflicted me with all your waves”.  What if I’m not treading water, but I’m enveloped in the very substance of life that God has sent?  What if the answer to “where is God taking you” is a wilderness of water, a dragging expanse of death, discouragement, depletion and demands?  What if He has allowed this for good, because what I really need and want is Him?  A theme of our study:  all true worship begins in wilderness.  Not in spite of wilderness, but because of it, because we need the gasping clarity of the struggle to stay afloat in order to know God’s grace. The party seems to be over, but I have a thin lifeline of hope that it’s just beginning.