Some ways in which YOUR life in COVID-19 (since it was announced on the very last day of 2019 it got the 19 designation, but this seems a bit unfair to 2020, which is bearing the brunt of this virus) is similar to our life every year, or ways in which we are probably more equipped to live in quarantine:
- We already talk to our parents and children by internet-based protocols. Group FaceTime is our go-to. We use What's App groups for much of our work communication, emails, zoom calls, virtual conferencing. So even though we are remote and have not always had phones or internet signals, we had a decade jump on the work-from-home digital life and the no-chance-of-human-interaction personal life. #social_space is how we live globally.
- We already shop in weeks-to-months increments, we already live off of dried beans and rice and pasta and canned goods much of the time, we already do without access to ice cream or restaurants or movie theatres. We come back from trips to Kampala with boxes of oil and bags of sugar, with tomato paste and crackers and other things hard to buy locally, every couple of months. We have been rinsing our local fresh vegetables in a very dilute bleach for two and a half decades. We already plant gardens.
- We know that electricity and postal service and running water and mechanical help and fuel and the general network of societal infrastructure is tenuous. Yesterday the power was out for almost 24 hours. We already have a couple of solar panels and a small generator. We collect rain water. We can walk to food shops. Africa is generally going to prove resilient I think.
- We already have to ration, make do, make choices. We already know that we can't save everyone, that death is real and present. I'm not saying that's good or right, but yesterday I had two infants who both needed one oxygen tank. The first one's mom had been in a long hard labor, and the baby had not been realised to be in distress from a cord around the neck. Scott walked into maternity to find the baby looking rather dead on delivery, and called me and we both worked to resuscitate the very asphyxiated baby, which was successful, but he needed oxygen. Then a few hours later a mother come with a 17-day old baby that looked like he was in septic shock. As Dr. Isaiah and I worked to get diagnosis and treatment, I checked the oxygen levels, very low. So I moved the single available source to the 17 day old, then checked the first baby. Uh oh. That one had dropped back to danger again off oxygen. Frankly I felt the newborn had a better chance of survival, but I was trying to make phone calls, find the right person with the key or the wrench or the capacity to hook both of them up, when one of the nurses said, "I have the key to the NICU where there is another tank .. ." So we could help both in that moment, but the point is, this kind of triage is constant.
- We already can't go where we want or do what we want a lot of the time. We live constricted lives in some ways, with limited choice, small ranges.
- And lastly, when the world constricts, we do have community. We live very close to each other. We have outdoor space, and we live mostly on one big connected compound, so for the last two weeks our team has still been able to interact with our 2m distancing. We have sunshine, and views of the mountains, and birds. I think our space at home is nicer than much of the world's.
But here are some ways that we are still finding this COVID-19AFRICA a weight.
- When our country does "stay-at-home", it means NO DRIVING AT ALL. We are expected to go to our gardens, to the market, to the bank, ON FOOT, and no crowds. This was instituted on Monday night, and Tuesday we were able to get an exemption for a few of us to travel TO THE HOSPITAL (12 km/8 miles so a bit of a long walk) only. I think this has been one of the hardest adjustments for all of us.
- Our rules are enforced by police with "canes". They walk around with sticks and regularly beat people who do not comply, so people are afraid. We also have armed military supervising the curfew. If you are out in the dark (7p to 6:30am) you are at risk of being harmed.
- We have no real emergency room to go to, no ICU to back us up. This may be more of a psychological than real loss, since ICU survival for this virus is quite low. Still it is sobering (our new most over-used word, but hey, it IS sobering) to know that if we need anything more than a very limited amount of oxygen, God alone can save us. That is always true, but rarely felt. Now it is quite real.
- We have no escape valve, no plan B that is sure, as we said above for medical but also for any political upheaval. With closed borders and zero flights, we are where we are.
- We are surrounded by people who have even less options than we do.
- We are surrounded by people for whom we have historically been a bit of a safety net, people whom we offer employment or education or health care or water. In this culture, we look to each other when times get tough, and we feel the weight of neighbours who have, and who will, look to us. How long can we keep paying salaries if our schools remain closed and no parents can pay school fees?
- Our rules are set by a single person with extensive powers, which in this global crisis will probably turn out to be good on a utilitarian scale of preventing illness and death, but still feels uncomfortably random at times as the implications of decisions are not always clear. Perhaps because of the no-go rules, we are experiencing the reality more than usual.
- When our hospital staff meets daily in the morning, we aren't discussing how many ventilators to buy, or when the thousands of new PPE's will arrive, or how many of the hundreds of new doctors and nurses will be hired. We are discussing, literally, whether police or doctors should chase out people who come in to sleep on the benches in the outpatient department at night, or the family members who sleep under beds who should be limited to one and not two. We are discussing whether sweeping the dirt driveway is aerosolising virus. We are discussing that on the night shift, the maternity nurse had no gloves, no pitocin (crucial medicine to stop bleeding). We are discussing whether malaria medications can be re-assigned from other small health units because we are out. We are discussing the difficulty of patients getting to and from the hospital because of the total ban on motorised transport. We are discussing how long suture supplies will last, or blood in the blood bank. This is a fragile system that teeters on based on the hard dedicated work of some brave people who aren't afraid to get messy, to improvise, to risk. But it is so marginal.
- I think everyone at this point is uncertain about what the next few weeks or months will bring, but for us there is an added layer of not just, how bad will the medical and economic impacts be, but how long can we hold on if our connections to our supporters dwindle, if something happens to family far away, if we personally become very sick, if the world order changes, if there is political fallout.
- And related to the above, the mixed messages and second-guessing just wear us out. Travel is dangerous, and spreads the disease. Everyone should stay in place. The US told citizens living abroad to stay where they were. But then our embassy keeps sending emails to say, there might be one more flight, there might be an option to leave, register your interest if you want to go. These long-shot chances being thrown out over and over are wearing.
And here is a last vignette that talks about the way we are always sticking out, and possibly that is good.
- We cannot blend in. In a district of 250,000 people, the only non-African-appearing humans are our team of 15 kids and 14 adults. Everyone knows what we do, where we go. And in this moment, we look like the humans from countries where coronavirus is skyrocketing. In some places that can be dangerous. So Scott asked a friend yesterday, whether he thinks people are worried about us walking down the road to the market. Should we send someone to get us food so we don't worry people? The friend replied, "Oh, doctor, you are wrong about why people stare. They are not worried. They comforted. They are glad you have not left. Please walk down the road!" So that was encouraging.
Uganda is holding at 44 cases, still mostly from returning Ugandans (42) who were in Dubai, or UK, or USA, plus a couple of Chinese nationals. Kenya has accelerated to 110 cases and 3 deaths. DRC, 123 cases and 11 deaths. Rwanda, Burundi, 3 cases, Malawi, zero. 180 countries, almost every country in the world is now affected. Spain, Italy, and New York state are bearing the brunt of it right now.
The photo at the top is a rainbow that prepared us for the stricter limitations on our movements this week. We are not going to get this thing completely right. We are going to make mistakes. We are in for some hard days. We are already experiencing grief on many levels. But God has not left us alone, God will not let this virus destroy us.
Our team continues to move through Eric McLaughlin's excellent book, Promises in the Dark. Each week seems to find us exactly where we are in our struggle. This week we looked at the idea of mystery. We believe many things about God, and in fact we know God relationally as loving and trustworthy. But then we look at what we can see in this world, and is a huge tension between what we believe and what we see. We can resolve that gap with denial of what we see, or despair about what we believe. OR WE CAN RESPOND WITH DEFIANCE. Eric's choice of that word intrigued me and led us to Job. If any character in the Bible models how to live in that gap between what we believe and see, it is Job, who constantly takes his grief right to God. He struggles. He engages. He asks. He laments. He defies the people who try to wrap up explanations in neat boxes, and instead chooses the greatest statement of faith: though he slay me, yet I will trust him (13:15). Job has the nuance of mystery, the avoidance of easy answers, and the defiant will to hold onto the one who holds on to us. Here is how Eric ends the chapter, and how we will close for tonight:
"Trust can persevere in the face of mystery because of a hope in a story bigger than what's visible, and because of the continued trustworthiness of God who's shaping the story."
COVID-19 has taken the story of 2020 on unprecedented paths, but we trust God's bigger story to bring a redemptive good that is bigger than what we see on our graphs.