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Friday, February 27, 2009

Caleb turns 14!!!

Which is double seven, the number of perfection. He is a great little guy (one of our old favorite books used to say that) but no longer little, taller than me and accelerating, smart and perseverant and funny and honest and strong. Judging from his appetite and his feet (now size 10.5), he's going to keep growing for quite a while. We pray that he grows in spirit as well, takes the difficulties of life as an outsider in a rough place and turns them into a resilience of soul. His Bday morning started early because his Chemistry teacher called all the class down for extra work on a Saturday morning . . . but we were able to get up and have a little party at dawn, with coffee cake and balloons and the most amazing yellow cleats from Grammy. The day is off to a good start!


I take some heart that after the fiery showdown with Baal's prophets, Elijah ran to the broom tree feeling completely wasted. In the last 24 hours we have received news of over-the-top provision, pulled off a successful outreach to about 250 women, led Bible study, taught a staff meeting on nutrition, discharged some back-from-the grave cured children (and Peter John, still hospitalized, is smiling and holding our hands). So why do I feel undone? For one, blessing in ministry can be exhausting. For another, when you push against darkness, you find that it has some substance, and pushes back.

And the most vulnerable place for me to be pushed, mothering. Two of my kids are struggling, one with a difficult and misinformation-laden teacher, the other with just emotional overload and keeping up with assignments. Tears flowed yesterday. Neither even wants to invite any school friends to their upcoming Bdays remembering the hassle we got when we last tried to do that for Julia's Bday. Then today I had to tell one of my Ugandan boys that his hoped-for spot in a discipleship- intensive A level program did not materialize: only one boy from Bundibugyo was called on for interviews, and it was his friend instead. He started to cry, and my heart just broke too, as I put my hand on his shoulders and prayed for him. Watching kids bump into the world's hardness, watching them be disappointed, sense their limitations or inability . . is so hard. A Ugandan colleague whose work could really help us let us know he's moving away from this district, frustrated. It felt like every patient's mother today needed to ask me for money, and my sympathy for their plights (often these are girls who are teenagers themselves, and when they spend days without a visitor and are out of food, I know they are truly needy) tends to wear thin when it is overwhelmed by sheer numbers. To top it off, I was actually on my way out the door remembering to be thankful for the slight margin of survival provided by my houseworker who usually washes up breakfast dishes and sweeps the floors while I'm at work in the mornings (a more significant task on Fridays post all-team Thursday nights) when I received his message that his back was sore so he couldn't work today.

Well, Elijah ran, slept, ate, and found God in the wilderness. All good prescriptions for weariness, some we can do daily or weekly, others periodically. But right now the Birthdays are fast approaching (Saturday and Tuesday) so it is time to clean up and continue, to pray for Mutegheki's heart, to hope and cook.

Festive Disease

Yesterday the Community Center buzzed with crowds of HIV-affected women, babies, and assorted relatives, 240 families in all. It was our quarterly Kwejuna Project distribution, a day that always involves so much planning and work and chaos and money. It is a day that I always anticipate being a burden of tragic stories and needy people. But it is a day that consistently surprises me with the atmosphere of a party. Women greet each other, and pass babies. Kids run around with their cups of porridge. WHM workers shoulder bags of beans and cartons of oil, health center staff and community volunteers listen intently to sort out details in interviews. People are weighed and measured, tested and recorded. Family Planning injections are offered. It is an effort that calls upon the resources of nearly our entire team, and then some. A couple from New York sponsors the 5 tons of beans and rivers of cooking oil and hills of salt that are given out to supplement the calories of these families as they fight their disease. This quarter we invited a Church of Uganda pastor from up the road, and a few of his colleagues, to man the prayer room, where they laid hands on any woman who wanted prayer. Reverend Kiiza then spoke to the group about Jesus' words to the winds and the waves: Peace, Be Still. Good words reminding us that God has power over natural forces, even those of disease, and that we can rest in the storm. It was the first time we had partnered with a different local church, and it went well. One of my students, no doubt sent by God, offered to help me out and the two of us spent a solid six hours screening the HIV status of every child, making sure they were enrolled for appropriate care. EGPAF visitors came by, and our district HIV focal person. As exhausting as it is, I'm thankful to be a small part of this picture of the Kingdom, bringing resources to the neediest in a spirit of prayer and love, partnering both locally and nationally, empowering many others to participate, a snapshot of what our mission should look like. Confronting disease, festively.

Thursday, February 26, 2009

A Flash of Good News

Just got a call from our Ministries Director Paul Leary, with amazingly good news of God's provision.  A private donor, whose interest in WHM in Africa grew out of a brief meeting in an airport parking lot in Rome facilitated by our colleagues . . . which became the foundation of the pediatric and maternity ward two years ago, another water line, and some buildings at Christ school . . . now decided to fund a huge grant proposal which will enable several significant Christ School projects to move forward, and enable the Sudan team to begin building.  In this time of financial uncertainty we are awed and grateful for a business man who is willing to part with many thousands of dollars over the next three years.  This proposal had been in the works for months (thanks to much work by Scott, the Pierces, Michael, and Paul), but it seems it landed in a spam section of the donor's email . . and was only retrieved in the last week.  Hard to remember that in early January we and the Pierces sat and prayed together over a bleak forecast for the year, wondering if God was giving us a message of radical changes to our mission.  There was simply no money, and the Pierces were weary with the prospect of facing the year.  Now six weeks later, we've seen our friends come through with sacrificial gifts, seen churches decide to partner, seen the mission shoulder lingering debt from past years, and now seen this donor give extravagantly.  God uses this to encourage us, to tell us to carry on.  We are almost as excited for the Massos as for us.  They moved to Sudan by faith, and have spent months subsisting very simply, waiting for funds.  Now the timing is perfect, as they have two young interning men with construction expertise who can pitch in to get the offices and housing off the ground.  Literally.  We thank God for moving hearts.

Wednesday, February 25, 2009

Happy and Bright

Would you name your child "Happy Bright" if you knew he was going to have AIDS?

Happy Bright came to clinic today, with his perky elf-pointy ears, sporting his Chinese-store-bought suit, and smiling expectantly. He's been in our program for most of his life, which at this point is about two months shy of four years. And though his stunted height looks more two-year-oldish, he's reasonably plump, and true to his name . . . happy and bright.

A Bundibugyo paradox, that an HIV-infected child and his mom can dress up for their day in clinic, because it probably represents one of the high points of the month (free cups of hot porridge while waiting, the festive sense of community in the crowd of fellow sufferers, the quick flash of candy from my pocket, the doling out of life-sustaining meds). And that they can be the happiest and brightest spot in my day, too.

Team Leader Epiphany

This particular epiphany came to me during church on Sunday, and related more to my wandering anxious thoughts being addressed by the Spirit in the atmosphere of worship and community than to the text or the sermon . .

God, and only God, can work all things together as in Romans 8 so that the earth is healed, the Kingdom comes, and individual good is maximized. I, on the other hand, often find myself thinking I have to hold in tension what might be good for a team mate and good for the team. In God's economy, those two goals are one. And for that I'm thankful. Because as a team leader, there are times when an individual seems to be struggling, to be unhealthy or depressed, to be homesick or floundering, to want to go back "home" . . . and one wonders if we do them a disservice to allow them to continue to serve here simply because their efforts as so much needed and valued. On the other hand, there are also times when someone wants to stay here, wants to push on through in spite of high levels of stress . . . and one wonders if we do them a disservice to allow them to stay because we need them. And for most of us, those two states can occur multiple times over the course of a year, or a day! As I sat thinking through this in church, how to encourage someone who dreads much about their life here and makes comments about wishing to leave, or how to wisely advise someone who might need a break they don't really want to take . . it was a great comfort to grasp, once again, that God always works so that an individual's needs are best met by the team's and the Kingdom's needs being best met, too. Whether that means extending a term or shortening it, He knows what He is doing.

So our job is to listen, to support, to watch, to trust.

And this morning my Sunday epiphany was confirmed, as we were led in prayer. A young team mate who decided to stay in Bundibugyo an extra year (and then felt the brunt of the loss involved) led us in looking at Mark 14, and the contrast between Judas who followed Jesus in order to gain something (and therefore felt it a burden) and Mary, who followed Jesus because of love (and therefore could pour out her precious oil to anoint Him). Given that it is one of my favorite stories and we also sang one of my favorite hymns . . . but I also came away from the prayer time awed that God is indeed weaving good for my team mate and good for all of us out of her difficult decision, that He speaks to her words of love as she pours out her life in a way that many might question. So I breathe a bit more deeply and entrust her into His plans, and feel encouraged to trust the rest of our team to stay there as well.

Tuesday, February 24, 2009

The News from Bundi

No unifying theme comes to mind, so I will ramble in the style of a news report.
Family Reunited.  Well, most of us.  Luke is still in Kenya of course.  His class at RVA put on their major event of the year, the Junior-Senior Banquet, which involved months of planning and days of set construction and rehearsal, sort of a prom/stage show/dinner/creative festival all rolled into one.  The theme this year was Charlie and the Chocolate Factory aka Roald Dahl, and they transformed an auditorium into the magical world of Oompah Loompahs.  Hope we can post some pictures soon to celebrate the ingenuity and perseverance required.  Luke's assessment: the evening was too short (7 pm to 1 am).  Which means everyone was having a great time.  Meanwhile I'm so glad to be home, with Scott, for a while.  Thanks for prayers.
Bundi is still Bundi.  Hadn't been home more than ten hours before one of my most desperate little patients, Peter John, was at the door early Sunday morning dying of dehydration.  The battle for that family still rages.  Small victories:  he was rescued with fluids, and I caught his sister smiling today.  And good news that our supply of anti-retrovirals, the life-extending anti-AIDS drugs, is supposed to arrive today.  We've been scraping by pill by pill for two months, and the situation was looking bleak.  Almost a quarter of my ward right now is HIV-affected.  Sadly a young woman whom I sponsored in primary school in our first years here, who is the sister of a good friend, died of AIDS on Saturday.  I biked out to her ancestral home yesterday evening to pay condolences to her mother and siblings.  She had several failed "marriages" in her short life (she was only 22 when she died), none of which produced children.  This morning a 15 year old's 790 gram 24 week premature baby died at the hospital.  My heart goes out to all these teenage girls, looking for worth and love and value and ending up fatally infected or grieving.
Investing in Leaders.  This is one of our themes this year . . .and before returning, I had a chance to visit nurse Asusi Mildred and her family.  She has completed her degree and is mid-way through her internship, and Heidi and STephanie and I had one of those rare evenings with her when we all are just people who live and work and relate together, when we can laugh and talk about politics and eat and pray, and not feel the barriers of nationality and status so blatantly.  It was a six-hour investment to get to her place and back (and nearly cost us our lives a couple of times when insane drivers passing on the wrong side swerved into our lane), but well worth it.  
Goats and more leaders.  Since I was driving back without all the family, we were able to arrange for a young couple John and Allison from the goat project in Masaka to come out to Bundi and consult with Lammech on the Matiti project, while setting up a computer-based tracking system for the goats.  We have now put so many in the community it requires a data-base to know which breeds are where, and how the genetics blend with each generation of breeding.  As they all spent the evening with us on Sunday I was again thankful for Lammech, who has a flair for community-organizing and teaching, and a heart for the people of Bundibugyo, and skills that bring life to others.  Another leader.
A big week.  We are already into the week, and there is much water to still flow under the bridge.  Today's main task was to clarify with the Nyahuka Town Council that the dedicated water line to the health center is NOT available for other users to tap into.  This should help assure water supply for little details like washing hands after dealing with cholera patients . . or mixing ORS to save a life.  Yesterday and today, goat training.  Today and tomorrow, nutrition education re-training in Busaru and Busunga.  Tomorrow through Friday, a site visit from EGPAF.  Thursday, the quarterly Kwejuna Project Food Distribution, with a couple of hundred patients and tons of beans, a measure of survival in the lean season of February.  Meanwhile the kids go to class and sports, the sun beats down, the patients show up, and life goes on.  We can use prayer this week (as always!!).
That's the news from Tuesday morning.

Thursday, February 19, 2009

Has anything good come?

Remember when skeptical people questioned Jesus' validity because he was from Nazareth? We heard a similar comment yesterday, after Stephanie presented her paper on the BBB program. She detailed the effort to design, implement, and refine the production of high-calorie soy-peanut paste for the treatment of malnourished kids, and did a beautiful job. As she sat down, the elderly British doctor who was chairing the session said "This must be historic, I believe it is the first time I have ever heard of research coming out of Bundibugyo!" I was so proud of Stephanie and Scotticus and our team at that moment, showing that quality medical care are innovation can occur even in our remote setting. Scotticus presented more data as a poster session, showing that though we give enough for each child to consume 680 kcal/ day, by careful dietary recall (thanks to Baguma Charles) they are actually only taking in 150 kcal of this product per day. This is why science and measurement is so important: rather than focusing on giving MORE food, we need to focus on getting the mothers to GIVE the food they are receiving! I like working in an area where the answers are still not clear, where we have to think and try.

60% of childhood death in Uganda is attributable to malnutrition, either as a direct cause or as a contributing factor in other diseases. Surely Jesus, who fed the lost crowds and took children on his lap, who called Himself the bread of life, would want His people to be bringing light and Kingdom here.

Fighting Hunger

I am sitting among 273 delegates from 19 countries at the first Uganda Action for Nutrition Congress, in Kampala. The first speaker, professor Tola Atinmo from the Federation of African Nutrition Societies noted that the US President Obama just signed a 787 BILLION dollar bail-out for the US economy . . . and asked when he could obtain a mere 10 billion dollars to bail-out the malnourished in Africa. More than 50% of Africans live on less than one dollar a day. We have heard from the USAID and WFP country directors, both articulate and compassionate men, from a UN representative and from local leaders. The guest of honor who opened the two-day meeting was the First Lady of Uganda, Janet Museveni . . . which combined with an increased terrorism alert for Uganda this week led to pretty severe security screening as we entered. The atmosphere is professional and yet passionate, a room full of African intelligentsia sprinkled with Americans and Europeans, representing governments and schools, aid agencies and hospitals, policy-makers and implementers. All are focused on the fact that Africa as a continent can not move away from being marginalized until our children are well fed. . . yet this is the only area of the world where the percentage and number of people living in extreme poverty is increasing. With 126 million undernourished children, with half of the continent's population stunted (a measure of chronic hunger), the challenges seem overwhelming.

But hope lies in the people, the champions of this cause. Most impressive so far, Dr. Stanlake Samkange. His points: our programs must be evidence-based because malnutrition has a multitude of causes and there is no single solution, success requires political will which can grow when governments realize that the cost of INaction is higher than the cost of action, and programs must build institutional capacity at all levels, especially locally.

So here I sit with Heidi our nurse, Baguma Charles our nutrition extension worker, and Scott and Stephanie our former team mates who have returned to academic public health in the US. And I pause to breath in the beauty of this diverse role in life we have as missionaries. We work hands-on at the grass roots level, we channel charitable gifts from the US as well as UN-provided food, we coordinate and partner with the government's ministry of health and with community organizations, and we invite the investigation and innovation of the researchers. Few people have the privilege of that combination, daily contact with the hungry, some responsibility for policy and planning, and the stimulating opportunity for advancement of knowledge. Praying that this congress gives us solid science for doing good, and creative ideas for helping others.

Wednesday, February 18, 2009

Standing in the need . .

. . of prayer. Scott will land in less than an hour, to face the multitude of issues that have awaited his attention (patients, requests, finances, mechanical problems, you name it, you can't leave here for six days and not have a certain number things pile up). Not to mention three kids who are NOT happy for their mother to leave AGAIN. Pray for him.

And for me, too. This morning has been an emotional slap, a reminder of what we face. Peter John's sister Grace came to clinic, the teenage girl caring for her orphaned brother who we bet on to pull him through some months back. He's so much better . . . but she asked to be HIV tested. And she's infected too. She's a bit old to have been carrying the virus since birth, so I started asking more questions, and finally it dawned on me what had happened. My gentle translator almost refused to ask, but now we're glad we did, Grace needed to unburden and had a good cry and I had one later. Grace and her brother had the same mother, but different fathers. So as Grace was caring for her dying mother in the end stages of AIDS, her mother's husband began to sexually abuse her. Now he's dead too, leaving her with an unwanted virus, no parents, and a sick sibling. Please pray for her to grasp hope, somehow. That on top of ward rounds and saying goodbye to my kids, rushing to make the plane . . . and to top it off, the bush baby Komba stopped chirping last night, I barely got him to take any milk today, and now I'm sure he's dying. Just a tiny little non-human life and nothing compared to the sorrow of those all around me, but still a way to grieve the pain of feeding and caring for a frail speck of breath that is then extinguished.

Tuesday, February 17, 2009

Parenting teens

Parenting teens . . . in most cultures involves conflict, part of the movement from dependence to independence, from a relationship of authority to one of mutuality. I'm working with five young people ranging in age from 19 to 23, and observing their reception in the community as well as hearing some of their issues from home life (yes, thanks to Heidi and my new Tuesday community health schedule I actually have time to listen to them sometimes!) has given me pause for thought. Some issues in this culture and in this period of history conspire to make the inevitable growing pains more severe: this generation will be more educated than any previous one, and more westernized, so that an older teen could be tempted to despise parents' habits. In the case of harmful practices like polygamy or wife beating, this is a good and necessary cultural shift. Yet respect for elders is a pillar of African culture. A twenty-year-old must show subservience to a 40-year-old parent or teacher. My students must do their community health teaching with assurance, yet be perceived to be humble. At the same time fathers can feel impotent when unable to provide ever-increasing school fees, or when unable to guide from experience as a child moves into never-before-dreamed-of paths like University. In a place where authority has been based on force, physical prowess, and the wisdom ascribed to age . . . we are shifting into an era where sheer muscle does not translate into survival edge, and where knowledge of the world favors the young. Yet we expect these emerging leaders to behave with humility and respect even when their elders intentionally snub them to show who is boss (cruel remarks or harsh demands perhaps the only way they know how to maintain supremacy) . . . and we expect the parents to manage with grace the balance of discipline and freedom that a teen needs to thrive and launch, even though most have practiced a pretty hands-off style since the child could walk. I don't see many people doing it well. And my heart is with both the teens and the parents, struggling to find their way in a rapidly changing world, to know they are loved and valued, to test relationship and feel its security.

Monday, February 16, 2009

Dwarf Galago: species identification?

We have decided to call our bush baby Komba, in honor of a character in a book . . . actually the book I wrote the kids for Christmas features a bush baby, which makes this one dropping out of a tree and into our lives a bit interesting. Komba weighed in at 45 grams, that's 1 1/2 ounces. He is 6 cm crown to rump (a little over 2 inches). In other words, he's tiny. His chirpy little voice calls us from his box nest in the bougainvillea outside our kitchen door, and we give drops of warm milk and pieces of soft papaya. He has human- shaped hands, a wrinkled snout, over-sized ears, scraggly dark fur, and a curling tail. His personality is, so far, persnickety.

His order is primate, suborder strepsirrhini, family galagidae, genus galago. I do not know if his species is G. demidoff or G. thomasi, or some other species I can not find information on. So if the biologist (?Jesse is that you) who commented that zoonoses were rare in this family wants to hazard a guess from the pictures and data, we'd love to know.

It must be Monday

Early morning darkness, I am awakened from a dream in which I'm teaching someone to suture a wound which happens to be on my own foot. I'm sure there's meaning there, the wounded healer.

This must be Monday, the beginning of the week scramble for school uniforms (are they shrinking that fast, or are the kids growing that fast?), doling out yoghurt and granola, pasteurizing the morning's abundant fresh milk, making tea for my workers, checking the internet, looking for a misplaced school book, making lunches. A patient's mother arrives at 7:30 to tell me that her son (Paulo, thanks for praying for him!) finally got his surgery on Friday, to close his abdominal wall and allow him to urinate normally. She is followed by one of my students reporting back from his interview trip to the intensive Christian discipleship and boarding school work program . . no results yet, so we sit down to make a strategy and budget for beginning school locally in case he is not admitted there. Meanwhile my three kids lug their 20 pound back packs (!) onto their backs and get their bikes and helmets and head off to school, I finish my coffee and show my workers where to plant some papaya seeds. A little milk and fruit for the bush baby, and I'm off too, to the hospital.

On the ward Heidi helps me get started, then she has to head out to a smaller health unit where we are re-training nutrition outreach workers to begin another cycle of the Byokulia Bisemeya ya Bantu (BBB, good food for people) program. As soon as she leaves I discover that three one-month-olds with similar diagnoses (pneumonia) but dissimilar sizes (2, 3, and 4 kg) have had their charts mixed up, and it since mothers often don't read and don't seem to concerned about what their kids' name is (seriously I'm holding the papers and reading the names and they are all looking at each other unsure), it takes some doing to sort it all out. As soon as we get that settled (and no harm done, all were on the same antibiotics) . . . an unconscious child is rushed in, a huge looking 4ish year old, completely zonked. Mother and aunt had left him with other kids, no one seems to know what happened, later dad thinks he was hallucinating during the night . . . he's cool to the touch and floppy and sonorous, with junky lungs. Most likely thing around here is a convulsion that coincided with a major temperature spike from the release of malaria parasites, but he doesn't feel hot. I ask the mother if she sells alcohol. No. Could he have gotten into a stash, or taken any other drugs? No. But of course they weren't exactly watching. We bundle him into the treatment room, send labs, push dextrose, and put up drips for malaria. While I'm doing the lumbar puncture and the clear spinal fluid is dripping out of a needle in his back, dad remembers now that he found empty bags of alcohol at home . . this is strong stuff, vodka sold in plastic baggies. That explains a lot, but we can't afford NOT to treat malaria and pneumonia given his exam, until our labs come back. As I round, and look into each little face, I am reminded of how much children have to fend for themselves, how often they are left to their own devices. Tempting to gather them all in to my idea of safety, but I also see that they cling to their mothers (even to less- than-reliable ones). There are worse things than being ill, and being taken away from your mother must be one of them.

Roadblocks on the way home, with police. I hear someone calling on his cell phone to get help from his dad, it seems the police are confiscating all motorcycles without license tags (called number plates here). Which is most of them. The road is eerily quiet. I like it. Maybe they will find our stolen nutrition cycle. In the short ride home I'm called by the midwives who need help getting HIV test kits for antenatal clinic, and another staff who asks me to contact the water line fundi to turn the water back on for the health unit, and I get a message that our appointed doctor will not be around 4 or 5 days again this week. I try to be patient but mentally tally about 6 total clinical working days in Nyahuka in the six months of the contract . . . though many more I am sure at Bundibugyo hospital, or doing administrative tasks.

At home the blazing sun makes the laundry on the line smell like it has just been ironed, it is almost too hot to touch. The team is gathering for an afternoon nutrition meeting: we are hosting Stephanie Jilcott and Scott Ickes this week, as they follow-up on research they had begun while here. Soon our Ugandan extension workers (Pauline, Lammech, Baguma Charles) join us to discuss progress or lack thereof, what percentage of chickens are laying eggs and why, how we will improve home visit follow-up of malnourished kids.

Just as the meeting is beginning Ivan arrives to say that the CSB gatekeeper has told him the gate is closing on admissions . . . he must be accompanied by a parent to get in. I had intended to do this in the early morning, but Ivan was mis-informed by an administrator that the process BEGAN at 2 pm. Not wanting to be difficult I did not appeal based on my hospital and meeting schedule . . but now it turns out that the process ENDS at 2pm, and it is 2 pm. So I leave the meeting in progress and go through the newly organized and efficient admission process. Teachers at the gate inspect his trunk, criticizing him for having 3 casual-wear blue shirts (2 are required, so we thought 2 was minimum, but it seems they are treating it as a maximum). They make him remove one set. I recognize the entire process is meant to instill humility, to show off the bat who is boss, so I keep quiet. We sign in, confirm fees were paid, sign agreements to abide by the rules, get a meal card and dorm assignment. I like his dorm teacher, who was Jack's cell group leader last year, and I like the process of helping him carry his trunk down and seeing his bed. A half dozen other boys are in the dorm, and the boy in the next bed seems to know Ivan already. The shutters are closed and the room is dark and crowded, but livable. I shake Ivan's hand goodbye. Last year I got in the car and cried after leaving him in the miserable little unfinished brick primary school dorm. This year Ivan looks like he could cry, but he doesn't, and I think he's just nervous. We're both glad for him to be in Christ School. Back to the meeting, then back down to the gate to enroll my S5 student. It is my 5th time through the process so the teachers are beginning to expect me back . . . but this time it is less pleasant because the S5 deadline kind of crept up on us and my boy does not have all his requirements (only 1 graph book not three, only 1 belt not 2, etc.). So the teachers are harsh and I have to beg for grace. In the end though he is settled in a good dorm, a new one, with a staff member who was once a missionary-sponsored-kid in Ndyezika's class. A nice connection.

Back home in time to get my own kids snacks before they head down to sports practice . . knocks at the door, . . my neighbor with a headache and a covered appeal for moral support on her side of a family issue, the little brother of a good friend who is looking for help with school fees, a man who wants me to examine his wife because she's losing weight, a church leader who is caring for orphans and wants me to help one with shoes. Now, a debriefing respite between me and my computer which has done me good . . though I don't expect anyone but my mother and husband to read this far. Then I will go on to preparing dinner, chili, which requires tomato sauce made from actual tomatoes, beans, vegetable, corn bread made without a mix, that sort of thing which is tasty but time consuming.

The day will end with the peace of dusk, candlelight, community, food and shared life. It must be Monday.

Saturday, February 14, 2009


This is the local name for the dwarf bush-baby, who is still alive on syringes of milk. We made him a nest in our bougainvillea, and are hoping his mother returns to reclaim him. He (or she, I have no idea) is about as ugly as any creature, sort of a cross between Yoda of Star Wars and the Bernstein Bears . . . but watching him lap milk is so satisfying . . . an extreme example, but the frailty and bizarreness of this creature draw out mothering. Meanwhile he chirps and burrows into the rags and licks his lips when we put milk into his mouth. Touching is still off-limits because of my zoonosis paranoia. .

Friday, February 13, 2009

Taking the Offensive

Mid afternoon, waves of rain showers, interspersed with pulsating heat.  Pat and I on our bicycles, loose stones and red dirt of the road, hurtling down hill and panting up hill, calls of "mujungu" from children in tattered clothes.  My favorite:  a 4-ish year old boy in a neck to wrist to ankle one piece long underwear outfit, covering everything but his hands and feet and . . . the only personal area of his body clearly visible in a rent.  We reach the appointed place for a community meeting, a local primary school which consists of four tin roof shelters with dirt floors and no walls.  A half dozen men and about 20 women flow into one of the school "rooms", with another dozen or so children.  These are village women, wrapped in kitengis, women who have rarely sat on a school bench.  Four of the five young CSB graduates with whom I've been working this month are there, with visual aids and good ideas.  I notice one of the primary school teachers who drifts over from her class is a young woman I sponsored for a year at Christ School--she failed, but was ever so grateful for the chance, burns having left her disfigured and bereavement having left her in the care of a grandmother who subsists on selling alcohol.  I was pleasantly surprised to see her thriving (though a bit worried about her level of teaching ability).  My students unroll two posters they have commissioned to begin the discussion of the harmful practice of cutting "false teeth", bhino, out of the gums of babies with diarrhea.  One depicts a together-looking woman giving ORS to her baby out of a cup.  The other pictures the same mother holding her baby in front of another woman with a knife, who has evidently just cut out the teeth, as blood spurts and drips from the baby's mouth.  And just as the discussion begins, the dark wall of cloud that had been blowing towards us arrives.  Driving, hail-force rain, heavy drops amplified by the tin.  Everyone huddles centrally, away from the soaking of the open sides.  The leader shouts to be heard, and women strain to answer his questions audibly.  

We have taken the offensive here, drawn the line.  Many practices can be applauded, many others ignored, but this dual business of slicing gums and then cleaning out any swallowed blood by forceful and dehydrating enemas, this is killing our children and has to be confronted.  And so we do.  I say little, until the very end, merely watching the students engage and implore.  There is skepticism and active chatter, as the women consider the possibility that they are being duped by witch doctors out to make money (going rate in this village turns out to be 2,000/= or a dollar a tooth, and on average they are told that 4 to 6 teeth must be removed . . . which amounts to a week's worth of family living expenses, no small consideration).  Our offensive does not go unnoticed.  We have an Enemy who will send pounding deafening rain in order to drown out our teaching, in order to continue to devour the young.

We end with hearing the village's concerns, many of which center on disappointing experiences accessing health care.  Pat and I leave them with two ideas for addressing their concerns: PRAY, because God hears the prayers of the poor, the prayers of mothers for their children.  And then get politically active.  The people embezzling the money, the people paralyzing the delivery of health services, are the ones they elected.  Ask questions.  Demand answers.  Take responsibility.  Easier said than done, but if today merely raises questions in a few minds, we will have been successful.  If one mother hesitates to allow a procedure that can end in needless death, we are satisfied.  If one person goes home and pours out prayers for workers with integrity to be appointed, and workers who steal and abuse their position to be removed, then we know that God is on the move.

We ride back home, steep hills again, feet slipping off the muddy pedals post-rain.  An unlikely picture of a military offensive, two pale not-so-young-any-more women in skirts and rain coats, huffing on bikes, while four kids in T-shirts make their way on foot.  But we moved out into Enemy territory today.  Whether we conquered any small part of it remains to be seen.

Thursday, February 12, 2009

Dwarf Galago

If my technical assistant (read, mechanically competent child) can manage we'll post a picture, but a quick note for old team mates and nature lovers.  We saw a first-ever new animal at team meeting tonight.  A dwarf galago (bush-baby), Galagoides thomasi I think, a distinct race that occurs in NE Congo.  First a slim squirrel-sized primate dropped down from the mango tree, stirred Star into a tizzy, jumped, ran up a couple of other trees and hopped back down, making its way erratically across the yard.  We got a good view of its pointy ears and over-sized eyes and long furry frayed looking tail.  Then the kids noticed a tiny baby version on the ground, it looked like a small wing-less bat with a long curling tail.  It did not move well.  Julia put on gloves to move it back into the tree and Annelise had the presence of mind to warn her against touching near the teeth . . . as Luke pointed out on the phone, there may have been a reason we saw these two tonight, perhaps they are sick.  And the primate to human transmission of viruses in Bundibugyo and environs lately has not been happy news.  Always something interesting in our yard!

ships in the night

This month we are practicing baton-relay parenting to a greater degree
than we ever have, and it is not ideal. However the alternatives are
for BOTH of us to miss events important to at least one kid, or for
the entire family to spend more travel money, or for 3 of 4 kids to
miss more school. So we have tried to compromise (great line from
tonight's movie, To Kill A Mockingbird, where the dad explains that
compromise does not mean bending the rules but rather a mutually
agreed upon path that minimizes the losses). I took Caleb to spend
the weekend with Luke for his 16th Birthday. Now I'm home with the
three younger kids; Scott had meetings in Fort today and moved on to
do some errands in Kampala before flying to Kenya himself for the
required work weekend that parents of Juniors are expected to
contribute to preparations for RVA's version of the prom, the Junior/
Senior Banquet. He comes back to attack the all-day task of medicine
purchasing and family shopping on Tuesday, then Wednesday we literally
switch places so I can attend the first UGAN (something like action on
nutrition network) conference where two former short term missionaries
are presenting papers related to research done through our nutrition
programs. It is a long stretch. Being the only parent right now, the
only on-the-ground team leader, the only doctor, the only adult in the
house . . . all take their toll. I much prefer partnering with my
best friend. Prayers appreciated, that I would live in the freedom
and peace of God's power and not rush around in a frantic panic!

Wednesday, February 11, 2009

Slumdog Diamonds

Thanks to our field directors I saw what must rate as one of the best
movies ever: Slumdog Millionaire. They had rented the DVD, then it
turned out that Caleb accompanied Andrew to a youth group meeting the
Sunday evening before our departure from Nairobi, and the Carrs were
going out to dinner with a departing team mate . . . leaving me home
alone with a video, which is a pretty rare event in my life. I keep
thinking about the film, and why it was so gripping. Pulsating music,
clever dialogue, creative cinematography, on-the-edge-of-your-seat
plot . . .but there is more. I think that there are occasional books
and movies that open our eyes to the reality lived by billions of
humans, painful to watch, wrenching, but important. Through the movie
we are forced to imagine encountering the depths of the world's
brokenness, first hand, defenseless. Like the children who live
within a stone's throw of my house, and in villages and city slums all
over the world, facing daily raw violence and sorrowful loss. But
more than an unblinking stare into all that is wrong sets this movie
apart: there is also the movement towards redemption: love persists
in the muck, goodness pushes back evil. Like Blood Diamond we see the
relentlessly pursuing love that mirrors God's, even when the object of
that love is damaged and rejecting like we are. Highly recommended,
though be prepared that it is not for the timid. Evil can not be
ignored in this movie, but a diamond of hope emerges from the mud.

The Scotts

Pictured above, Dr. Scott with Baby Scott, the first child born in our new Pediatric-Maternity ward a year and a half ago. He was born to an HIV-positive mom who took her prophylactic medication, weaned him to goat's milk provided by the Matiti project at age 6 months (she also named the goat Scott, by the way), and ended up with a healthy uninfected boy. He came to greet us in the clinic today sporting a spiffy suit, so we had to snap a photo.

More encouragement today: first patient in line, Kambale, growing and thriving, the little boy whose mother struggled to find her way home from Northern Uganda and deposit all her children with her own mother a week before dying of AIDS. Her act of bravery and kindness saved Kambale's life, at least for now, as his competent illiterate little old grandmother faithfully maintains his medicines. Next, one of my patients missed clinic and his mom just asked for a medication refill . . . because he started school. This was a child whose life hung in the balance for months as a baby. Now he's healthy and big enough to go to kindergarten. Later an unfamiliar-looking 13 year old girl was shown into my exam room, with records from Kampala where she had been on ARV's through a Baylor/Mulago initiative. It took me a while to realize she was one of our first diagnoses of HIV, many years ago. She also is healthy and strong and attending school, but has moved back to the "village" with her mother.

Who would have imagined that our AIDS patients would provide the clearest view of God's redeeming mercy, of hope?

Tuesday, February 10, 2009

Space for Advocacy

The sword of the cell phone came into play today, advocating for the orphaned and sick, trying to connect kids to resources, knowing I can not solve the problems. Kweyaya Paulo, a 4 year old who was born with a nearly blocked urinary system and rescued later by a blunt procedure creating a hole from his bladder through his abdominal wall. He leaks urine, continuously, in a land without pampers. He is always damp and smelly. After well over a year of trying to get him the public surgical care which is in theory available at the national referral hospital (8 admissions all ending without any substantial help, but who is counting?) I admitted defeat, and thanks to the gracious services of a hospital administrator at IHK we connected today with the only OTHER urologist in Uganda and have arranged surgical correction of his defect through Mengo hospital (Church of Uganda). It will cost about $350. Which is the per capita health expenditure for several whole villages, so this is not a sensible use of funds from the public health perspective. But even Jesus took note of certain specific suffering individuals, and this boy's mother has never given up. Pray for his surgery next week.

And for little Fathila Katusabe, another 4 year old with a dedicated mother, whose seizures and developmental delay stem from an early infection with meningitis. She needs to see an orthopedic surgeon for release of tight tendons which cause her to limp. After 3 failed attempts referring her regionally, I connected today with an Italian Orthopedic Surgeon who agreed to evaluate her next week, also in Kampala. Fathila's mother's mother died during the Ebola epidemic. I know this lady has suffered a lot, yet she remains hopeful, and thankful. Pray that the lame would walk.

Lastly, I spent time today advocating for an orphan student who would like to continue his studies. He's a good boy, with potential, and almost no supervision or resources, medium good grades but not the top of the class, not popular with the staff. I feel like he needs to get away from the influences of Bundibugyo for a couple of years, get out of the rut in which he's been pegged, and am sending him to interview for a place in the Cornerstone Leadership Academy, a Christian intensive discipleship and A level program that is academically very successful. He'll be competing with kids from all over the country for only 25 spots, so the chances are slim. Still, we have seen God going ahead and fighting the battles left and right this year, so why not hope? Pray for M.J.

Nouwen defines discipline as creating the space in which God can act. This resonates with the picture of 2 Chronicles 20: the armies held back behind the choir, stopping to first fast and pray, then arriving on the scene to find the victory already accomplished. I would like my life to look like that this year, a few phone calls and then getting out of the way, trusting these children into God's hands.

Monday, February 09, 2009

Celebrating Other Joys: Personnel

John and Loren Clark, with their toddler son Bryan, have been raising support to join us in Bundibugyo for what feels to all of us like a LONG TIME. But they and we have consistently reminded ourselves that God's time scale is not our own, and that He has all the resources He needs to finish off the pledges in a moment's notice. This weekend, He did! With one swoop of gracious generosity, a donor took them from 85% to 100% monthly pledges. We are so grateful, not just for the Clarks but for all our team. We look forward to the joy of adding this young family into our family, and we know that they will be channels in which the blessing of the Spirit will flow for the good of many hungry and hurting people. John has experience with nutrition and sustainable agriculture and a passion for holistic ministry, and Loren has the skills and heart of a nurse.

We also got the excellent news this week that the doctor/educator couple who visited us in January decided to apply as missionaries with WHM. We enjoyed their company for a week, and would love to see God open the doors to call them back to Africa. They will be joining a young woman who is also a teacher in this Spring's intake process. We are excited to see God beginning to answer the very specific list of positions we posted and asked people to pray for (that's 2 of the 5 if both are confirmed!). We still have immediate openings for a family with a focus in education to partner with the Pierces, and for interim team leaders to shepherd our team, overlapping now with us and taking overall care while we are on furlough. Lastly a youth worker, someone who counsels and advises and ministers to our CSB grads and other young people. . . .

And one more plea, just in case this reaches the right person. Luke and a number of rising seniors at RVA would love to take AP Physics in the 2009-2010 school year, but there will not be a teacher for that class at RVA this coming school year. I'd be happy to put any aspiring High School Physics teachers in touch with the school. It is a tremendous community of people dedicated to supporting missions in Africa, and the students in an AP class would be a fun group to teach.

Celebrating Sixteen

Caleb and I just landed back in Bundibugyo from our weekend trip to Kenya to celebrate Luke's sixteenth birthday--thanks to the generosity of some fellow-missionaries we were able to hop on a MAF flight this morning that kept our total time away from home at less than three days, and will allow Caleb to attend afternoon classes and me a couple of meetings. Amazing.

The Birthday Celebration was just right for a sixteen-year-old American-African. We picked Luke up on Saturday morning (thanks to our field director's the Carr's car . . ) and drove down the rift escarpment and over the valley floor to the extinct volcano Mt. Longonot. The area is preserved as a national park with a smattering of zebra, giraffe, gazelle, and elusive unseen buffalo and even leopard. We climbed a very dusty and strenuous trail to the rim, then hiked all the way around the edge. The peak is almost 9 thousand feet, with views out to Lake Naivasha to the west, the shelf of the Rift Valley escarpment to the north, and the dim and dusty settlements of the valley. Walking around the crater we balanced on a narrow trail with sheer drop-offs on both sides. It took us about four hours at a brisk pace to do the whole trail (and I mean brisk for teenage boys, which is on the edge of survivable for middle aged moms). The intense equatorial sun, the spectacular views, the complete freedom from other people, made for a wonderful day of just talking and enjoying each other's company. After rehydrating at the bottom again, we drove back to RVA. Luke's guardians the Newtons had prepared a great dinner for all of us, and later we joined the boys in the dorm watching a movie at the dorm parents' apartment. Sunday morning the dorm mom, Michelle, helped me make a big cinnamon roll, bacon and egg breakfast for 24 (all the dorm boys plus our families). We brought 16 fire-cracker-like sparkling candles that almost burned down the dorm (or smoked out the inhabitants) and were great hit with a bunch of high-school males. After church Caleb and I joined Luke for lunch in the "caf" and gave some moral support during homework, then had to say goodbye in the late afternoon to return our borrowed car to Nairobi before sundown and be ready for this morning's pre-dawn flight. Luke had another dinner and cake with the dorm parents last night.

I am thankful for Luke at 16: growing in confidence, able, tall, friendly, creative, cutting to the point, working hard. He's taken a lot of change in stride this year. I'm thankful for Caleb as a traveling companion: paying attention to directions and instructions, seeing the world with his sense of humor, carrying most of the stuff without complaint. I'm thankful for a weekend away from normal life to focus on two of my boys. I'm thankful for the unusual experience of traveling light, just two backpacks for the two of us, and traveling quickly, by air. I'm thankful for the nurture and challenge of RVA at this point in our lives. And I'm thankful that God saw my mother's heart and allowed me to drop in for this Birthday.

Friday, February 06, 2009

On an adventure

First, keep praying for the recovery of the motorcycle, but the good news is that one of the two bikes was stored in a separate location last night and therefore was not stolen as we had feared. So only one is missing. The bad news is that the Masso garage was only one of six buildings breached by the thieves: they rifled through papers and wreaked havoc in the translation and literacy offices, the BundiNutrition office, the classroom used by the Deaf School on our property, even some store rooms. A laptop used by the Lubwisi literacy program was later recovered in a ditch, with some recording equipment.

Now back to the adventure: This post is being sent, amazingly enough, from wireless internet in ENTEBBE AIRPORT, which has become a truly modern over the last few years. Caleb finished his Beginning of Term exams and I saw all my patients this morning, then we hopped on a small MAF (Cessna 210) plane in the afternoon, with Juliet who was taking Arthur to meet his maternal grandmother for the first time. We lifted over the ravines where river-side laundry casts a colorful confetti drying in the sun, saw kids scrambling for views of the airplane from the dust of their compounds, glimpsed the orderly rows of huts at the main army barracks and the sprawl of tin roofs which is town. Then over the bare shoulder of the mountains, the volcanic craters of Fort Portal, the countless miles of papyrus swamp, heading due east all the while, to Entebbe. Arthur was perfect, Juliet was enjoying herself, and Caleb and I were GREEN. Delicacy prevents me from disclosing how many bags were filled from our stomachs, but let me say that the lion's share was not mine. Sigh. Afternoon flights, pockets of warm air ascending, lead to turbulent times down in the no- extra-oxygen small-plane strata. We are glad to be sitting here in the airport on solid ground for a couple of hours, until the next phase of the adventure. We will reach Nairobi tonight and then on to Kijabe Saturday morning. Luke turns 16 on Sunday. I sat a few yards from here with him as an 8 month old when we landed in Uganda for the first time, a bit lost and alone (our ride arrived a few hours late . . .). It has been an adventurous 15 1/2 years since then, and I am thankful to be rejoining him for the commemoration of this special Bday.

Thursday, February 05, 2009

Under Attack

In the last week, unoccupied buildings on the mission have been broken into three times, on three different nights. One time we can write off as desperation (rising food prices, school fees due). Two, we began to wonder about security issues, lack of consequences. Three tells us we are under attack. The first time was the night of the Super Bowl, which here was on from 2am- 6am in our time zone. We set our alarms and about half the team slept over on our floor, so when our lights went on and we began to cheer in the middle of the night we suspect that the thieves at the former Gray home got spooked. The next morning we discovered that a couple of mattresses and sheets and spoons were gone . . . but electronic equipment piled by the door had been abandoned. The second time was an outbuilding (also at the former Gray house) from which we could not detect any missing items. But last night was a doozy. Someone pried open the lock on the Masso garage and stole one of our BundiNutrition outreach motorcycles (value ~$4000). This is the machine which Baguma Charles rides hither and yon, doing trainings, making home visits, teaching, encouraging, delivering food supplies, making reports. 
They also broke into four other offices around the mission including the BundiNutrition office, our WHM worker tool store, our Deaf School classroom, and the Translation Office.  I just felt sick at the prospect that the Lubwisi Translation computer might have been taken or damaged. 
Thankfully, that computer was taken home by Charles Musinguzi, our translator, so no Lubwisi  bible translation files were lost.  My next action...verify that they are backing up those bible translation computer files in a secure site!

So Scott will spend half his day making a police report, and we will file notices with the organization (EGPAF) which funded the purchase of the motorcycle, and we will scramble to find other means of transport, and we will hire three night watchmen, something we haven't done in a long time. And we will pray, and ask you to do the same, that the "God of the Angel Armies" will send a few troops our way. As an act of mercy as well as justice: women with AIDS and hungry children are going to suffer the consequences of this last break-in, and the consequences will eventually catch up with the thieves.


Post-team-meeting-and-pizza, sitting outside on our little bougainvillea-covered veranda, dim moonlight and stars, cool breeze. About half the team drifted home for early bedtimes, and half stayed chatting. I brought out candles and a new game sent in a care package: BeRhymed, a combination of catch-phrase, charades, and pictionary. We laughed at Jack's drawing of "shocked" and my acting out of "vampire", listened in amazement as Ashley took her team's score far into the lead. Then it was Caleb's turn, and as he drew clues I leaned closer to get a better look by candle-light as we raced the timer. Suddenly the night got brighter, much brighter. At the same moment I heard crackling near my right ear, smelled the acrid odor of burning hair, and saw everyone else's face register the same little "shock" drawing that Jack had penciled a few minutes prior. My hair was on fire. It only lasted a few seconds, by the time I jumped up beating on it with my hands it was out, I never even got to STOP, DROP, and ROLL. It seems the cheap local Ugandan hair goop I buy here, Venus Hair Food, to dampen down the frizz, is a petroleum based product, and quite flammable. Thankfully I don't use much, so it burned off in about three seconds. And thankfully I have a LOT of hair, so the loss is not even hardly noticeable. But for the rest of the team and family it was quite a sight, Jennifer in flames.

Wednesday, February 04, 2009

Reading nature

Early morning, pre-dawn dimness, the flutter of fruit bats with their
paper-thin wings and ominous swoops, returning to roost in the royal
palms, darting under the eaves and through the trees. I stand in the
yard and look up as one of the bats erupts in shrieking. An eagle
hawk grabs an oblong bundle of bat, holding it in his talons as he
flies low and powerful between the trees, confident, conquering.
Since ebola, it is hard not to see bats as evil, harbingers of
infection and rustlers in the dark. In our prayer times this week
we've been focusing on the fact that the unseen reality trumps the
visible problems . . . So as I stood watching this improbable scene, I
thought of angels, swooping down with precision timing and selection
to protect us from a particular crisis. Outnumbered but still
individually strong, pulling one problem out of our way, but not
eliminating the swarm of evil. Yet.

Later, the hospital is abuzz with the events of the night. Scott is
told by the staff that a rather prominent business man, a trader on
cocoa, who lived nearby, died. How? He was relieving himself outside
in the night when he was attacked by a snake and bitten SEVEN TIMES.
In painful places. People told us with assurance that the snake even
followed the man onto the hospital ward. I suppose it is reasonable
to assume it could have been gathered up in his sheets or clothes as
it tried to escape while his collapsed form was being transferred to
care? But the idea of a snake that stayed around long enough to
strike that many times, had enough venom to kill a grown man within
the hour, and appeared even on the hospital ward, is rather grim. A
tangible enemy, to be sure, unlike the subtle viruses, mutated genes,
or creeping fungi that attack most of my patients. I came home
forgetting the small victories (a preemie reaching 2 kg thanks to his
mother's skin-to-skin incubating care, and going home; a stick-figure
little sickle cell patient now smiling, naked except for her stuffed
giraffe tied to her back, having climbed from the ditch of
malnutrition to resume her march along the road to health) . . . in
the tragic arrival of a primary-school age child who presented with a
massive brain tumor growing out of her nose, her blind eyes swollen
shut, beginning to have trouble breathing, her disease having
progressed months untreated and now nothing more to do than palliate.

I am reminded, as I am many days, of the apt watch-phrase: "How goes
the world?" "The world goes not well, but the Kingdom comes." We
could use a few swoops of the hawk.

Tuesday, February 03, 2009

Deadly Beliefs

One of the great gifts of having a team nurse is that Heidi has allowed (?insisted) that I not do inpatient rounds EVERY day . . which has freed up Tuesday mornings this month for one of my first loves, community health and medical anthropology, the exploration of beliefs and their impact on health.  There are many strong and healthy and God-reflecting aspects to local culture.  There are many other neutral practices.  But there are a few deadly ideas, beliefs which result in much suffering and needless mortality.  I applaud the former, ignore the middle, and vehemently protest the latter.   I frequently see children in the terminal stages of dehydration and infection who have come to the hospital in a last desperate attempt to save their lives, after their well-meaning parents have subjected them to some barbaric practices.  Though I plead and lecture on the ward, it is a losing battle.  So this month I invited five recent CSB grads (3 of my male students and 2 girls whom I came to know well as their cell group leader) to conduct qualitative research on the topic of "bhiino", or "false teeth".  

These kids conducted 50 interviews with a cross-section of community members, and today we gathered to discuss their results.  The basic idea is that severe diarrhea in infants is caused by the presence of  evil abnormal teeth hidden in the gums, and these offending teeth must be cut out by specialists in the community, extracted by knife-point from the toothless gums of the babies.  This cultural practice filtered into Bundibugyo in the 1970s on the heels of Idi Amin's soldiers, who carried the idea from their home regions to the North.  By now it is so pervasive and popular that EVERY woman and most of the men interviewed reported having taken at least one child for this procedure, and EVERY informant believed beyond the shadow of a doubt that such teeth exist and must be manually extracted to save the life of the child.  

Sadly, the reality is that the mutilated babies refuse to drink, becoming more dehydrated, and the wounds from the non-sterile crude knives often become infected.  We say on our team (in memory of Michael Masso and Kevin Bartkovich) that we are life-long learners.  And though I've been speaking out against this practice for 15 years, I learned new things today.  First, that mothers blame themselves when their baby gets this problem, for not wearing herbal protective charms around their waists consistently throughout their pregnancies.  This struck my heart, because I know that parents allow and in fact pay high prices for this procedure because they truly want what is life-saving for  their child . . and now I realize the underpinning of guilt that makes the whole scenario even more desperate.  Secondly, I learned that the what I consider to be the second most deadly belief, the forcible administration of enemas to babies, is not a completely separate entity but is often combined with the tooth extraction.  So the baby who was already sick, whose mouth has just been sliced up, is further compromised by the dehydrating and painful procedure of having herbal solutions blown into  his or her bottom through a pumpkin stem.

This week's task:  for the young people to design an intervention to combat these deadly beliefs.  The encouraging thing is that our communities WANT their children to survive and are going to great lengths to ensure that they do . . it is just the tragic misunderstanding of reality that turns their heroic efforts of love into the fatal incisions of destruction.  I read to the group from Matthew 2, Revelation 12, Jeremiah 31, all referring back to Genesis 35:  the battle is real, and the battlefield is all too often the vulnerable bodies of babies.  Rachel weeps when her children are assaulted. Let us comfort her with truth.

Back to School

The mile of dirt road which stretches in front of our house hosts no less than five primary schools (3 large government schools and two major newly-opened private ones) and three secondary schools.  I would estimate that these 8 institutions enroll over two thousand pupils, not to mention that dozens of others use the path to head further afield.  So when the school year officially began this week, let's say it was quite noticeable!  Clusters of boys and girls, from tiny tots to burly teens, in solid color trousers and white shirts, maroon shifts and checkered blouses, a palette of colors, shapes, and sizes, all flowing up and down the corridor.  This is the first new school year since my neighbor died, and his successor son decided to observe a cultural practice involving sending the wives of his father back to their pre-marriage relatives (in spite of the fact that these women have lived there for 20 to 40 years . . .).  So I ended up taking the two teenage parent-less girls to sign into "Parental Care Primary" school.  It was also the first year of a stricter and more organized CSB entry process, so I went there to sign in my usual boys.  It was somewhat festive, rubbing shoulders with other parents, many of whom I know, respectfully waiting my turn, paying fees, saying goodbye.  Students greeted each other, harried staff members searched through trunks to enforce the proper clothing and shoes and books being brought.  And so the 2009 year begins here, hopeful.  

Give A Goat

A comment on the blog asked if we require goat recipients to return the first female offspring to the program. The answer is YES, we do. Only 8 were returned in 2008, but our extension officer anticipates at least a dozen more coming soon (female kids that he's seen in his home visits). The vision is that this program eventally become self-propagating, so that needs for immediate individual assistance can be quickly met as mothers die or as HIV-infected mothers wean their babies. But we also have a growing vision for the broader problem of chronic widespread under-nutrition in toddlers and preschoolers. Bundibugyo's stunting rate is 43%--that means almost half of kids are shorter than the lowest cut-off for normal in a healthy population. This happens because small bodies faced with repeated cycles of infection and access to minimal calories and protein compensate by slowing their linear growth to preserve survival (even our own child experienced this in his second and third years of life here, though he's recently miraculously sprouting lengthily). Our dream: the male dairy breed goats that we import will be used by every village, crossing with the hardy local goats, to eventually produce flocks of little milk-makers, adding high-quality protein to the marginal diets of most children. The Joy Children's Center in Masaka has provided most of our goat stock and we continue to work together towards this end, thanks to Karen's years of establishing the program, Lemmech's daily forays into the bush to follow-up on goats, Sarah's careful records and accounting, Pat and Heidi's patient screening of potential recipients, our Nairobi team's creative assistance with hand made ornaments, our Sending Center's coordination of gifts, and the 117 extravagantly gracious people like the commenter on the blog who actually purchase these goats for poor families. It's an amazing partnership (remember our themes!), made even more powerful by the prayers which accompany the giving.

Sunday, February 01, 2009

A Vision of Hope

The 2009 school year begins tomorrow . . . and so tonight our WHM team joined the CSB staff for a prayer walk, bathing every corner of the campus in praises and supplications. David shared a few words about the faith of Caleb in the Bible, who was not intimidated by the giants in the land of Canaan because he sensed God's power to be more real. Annelise kept us moving from dorm to dorm, classroom to classroom, in small groups and then all together in a circle of prayer. We prepared the way for the students by asking God to do great things: to protect from disease, to give a passion for learning, to provide adequate food, to inspire teachers, to draw forth worship, to change lives. It was a beautiful tangible picture of our partnership, and a way for us to collectively acknowledge that like Caleb we know that the God we serve is the One who can bring true change to CSB.

And our vision of hope was boosted by the weekend's news of the O Level exam results. Christ School emerged as the leader in Bundibugyo once again, with 5 students in Division One and NO FAILURES. To put that in perspective, we had 5 of the 8 division one scorers in the district, but only 51 of the 435 students. That means a Bundibugyo student at CSB was 8 times more likely to score in the top tier than average. And in our district more than 10% of students fail, but none of ours did. We still have a long way to go to meet the highest national standards, but this was hopeful news.

And so we meet the new year. The giants in the land are real (alcoholism, abuse, cheating, mediocrity, rebellion). But the grape- cluster vision of what God can do makes it worth the risk to move forward.