countdown to take-off

In about 8 hours we should be driving out of Bundibugyo, on the way to Kenya.  Every two years the Christian Medical and Dental Association puts on a 2-week conference for missionary doctors, so we can stay current with our continuing education hours and keep our medical licenses up to date. Of course it is also a wonderful opportunity to be encouraged, to not be ALONE.  Due to the timing of my Dad's death we missed 2006, and the post-election violence in Kenya led to cancellation in 2008, so it has been six years since we last attended.  This time we will be taking along nurse Heidi and PA Scott Will, and meeting our new doctor-colleague-team mate and family Travis and Amy Johnson, who will land in Nairobi tomorrow and wait for us.  And Ashley, to teach Jack and Julia while we're in class.  We're quite an entourage of 7 adults and 5 kids . . made even more complicated by the news today of ongoing insurmountable car difficulties for the Zoolander (the former Bart-mobile shared by the singles) which means that our truck will be the sole ground transport for all.  All of us but Scott Will are sharing a very simple guest house at the Moffat Bible College adjacent to Kijabe and RVA.  Though it is about 40 minutes' drive from the conference site, no kids/families are allowed at the conference facility to maximize space for missionary and national doctors.  So we'll be in a sort of commune, cozy, probably not overly-comfortable, but likely to be memorable.

Meanwhile, that means with travel to and from, we'll be away from Bundi for almost three weeks. Which feels like a LONG time, and less-than-ideal timing.  Scott has been severely pulled and pushed by the inevitably bumpy transition into the new school year.  And so leaving for a few weeks puts a huge strain on the last day here, friends still desperate for school fees for their orphaned siblings, our beloved dog with maggots from sand-flies, biting ants swarming outside our bedroom window, deciphering complicated spread sheets and making adequate money available for programs, persisting at the bank long enough to will one's way through the passive-aggressive managers, sitting down with visitors, the typical afternoon crisis of a fever in a neighbor's kid, the usual.

However, there were some reminders during the count-down-to-departure today that God smiles.  My first patient was sporting a very clean, spiff, University of Virginia (our school) T shirt.  And nothing else, of course. He was a 4 year old sickle cell patient whose smile and energy belied his hemoglobin of 2.2.  Of course we see all kinds of American-slogan shirts all over the place in the thriving used clothes trade, but I'd never seen a UVA shirt that wasn't ours before.  Fun.  The next bed held a child from Congo with severe malaria, no history of immunizations, looking bewildered by the whole hospital experience.  I shamelessly give every patient a little wrapped candy as I begin my exam, which distracts them, and as a gesture of good will counteracts the rumors used to scare children that white people are spirits who have come to eat them.  This kid looked at the candy so hesitantly, and held it so carefully, I was pretty sure he'd never seen such a thing before. Throughout the day I was struck by the competence of Olupa and Asussi, the nurses I love to work with.  I would put my confidence in them over most anyone I know (doctors included) to care for critically ill Ugandan children.  Then Nathan walked in to join us, and the next patient was one whom he had identified at an outpatient nutrition program months ago.  The child had been severely ill, basically starving, and would have died unless his path crossed with Nathan's and BBB.  He completely recovered and was back for a minor gastrointestinal illness.  Then my favorite little guy at the moment, Obeni, with TB, reached his weight goal today, another small gift for me as I hate to walk away from these kids.  Later Nathan told us about Day #1 at our newest outpatient site in Butogho where he spent the afternoon, an area that our extension workers identified as having prevalent nutritional problems.  Baguma Charles trained the clinic staff and volunteers in January, and today they screened kids for enrollment.  Everyone was so excited to see the program begin that they flocked to the health center, calling their neighbors to join, drawing pasers-by off the street.  Nathan estimated that at least 200 kids showed up, mostly NOT malnourished.  But among them they picked out 17 who were severely malnourished enough to qualify.  

Only 19 more minutes in today.  And the countdown of hours until we load the truck and pull out ticks on.  Time to finalize packing, to rest these kids in the Healer's hands, to accept what has been left undone, and go.  So we can come back, more ready to care.