rotating header

Saturday, April 04, 2020

#COVID-19UGANDA day 14: collateral damage, collateral grace, deepened not diminished

This is how our days go: pushing curfew limits for a bit of exercise in the morning, coffee, Bible, prayer, urgent texts and emails that accumulate from other time zones, perhaps a knock at the door, a question or crisis. Into the car by 8 for the 8 mile drive to the hospital, hoping not to be stopped by the police as we don't have a "COVID-19 MEDICAL" sticker yet, but we do have a written permission from our district government. The oddness of a staff meeting, standing 2m apart, outside, hearing the overnight report, the latest Ministry of Health directives. Rounds, patients, assessments, procedures, all while breathing through a mask in the 90+ degree heat of wards with little airflow, all while spritzing hand sanitiser liberally and having various staff all "borrow" mine as the level keeps dropping. Connecting here and there with Jessie, with Scott, with Marc, with Ammon, with Isaiah, as we discuss patients. Early afternoon at some point between 1pm and 3pm we finish and take our masks off at the car, carefully folding them into a cloth bag that I put on the super-hot dashboard to bake. More sanitising. Friday we walked another half-mile through town to the bank, as the local government had hinted darkly at confiscating our car . . . didn't want to risk any movement except home to hospital in a vehicle. Walking is pleasant, it slows the pace, makes you aware, makes you part of the community . . .but it does also add an hour here and there to a day of work. Back to our house by 3 for two hours of meeting with team mates about work, plans, future, coping. Walk to Nyahuka, our closer town (half mile?) to check on CSB staff with a sick kid, to buy milk. Stop back at mission house for another 45 minute meeting/check-in. Back through our gate before the dusk 7pm curfew. First chance to do dishes, to make dinner, to listen to news. Eat, connect with family in USA via texts or calls, answer emails, listen to our Ugandan President's long evening speeches, work at computer until 10 or 11. Sleep.

morning walk with mountains, thinking Psalm 121
a few views of morning staff meetings with #social_spacing
the unsung heroes of COVID, the cleaning staff
the corridors between hospital wards
children are still malnourished no matter what the world is wobbling about; Jessie doing weights
a very sick baby, I did an LP, and actually got gram stain results. Not good news but at least we know what we're dealing with.
TB treatment, malaria treatment, malnutrition treatment, transfusions . . . must go on!

(pc Marc) a sweet moment Friday, Baby Flavia the 800 gram preem whose mom died late 2019 is now a fat and happy thriving 4 month old!!! thanks for prayers. 
Scott is happy to be back in the surgical theatre
discussing a difficult case with Dr. Ammon and Dr. Marc, thankful for colleagues
For my kids, a Man U fan dad and his kid named Rashford . . . 
post work walking through Bundi town to bank, living proof of presence
the bank is enforcing #social_spacing
stop in the market for passion fruit; we are still allowed to buy and sell food

waiting for the evening briefing
living in the reality of hanging on the words and desires of the leader

So at this point we aren't doing virtual museum tours or scouring for great podcasts, we barely have time to manage life.

Today I'm thinking a lot about the collateral damage of COVID. Only 48 cases in Uganda, and the zeal with which this country is tracing contacts and enforcing social space is pretty impressive. Because we are remote and poor, our exposure has been later and more limited. But that does not mean we are not impacted. In the 14 days since COVID came and restrictions ramped up, Scott has had four pregnant women with a ruptured uterus come to the hospital. It used to be 1/month was remarkably bad, now 2/week is a new normal. If you go into labor and things go bad, and you can't manage to get to help because there is no transportation, there is curfew, you're afraid, the health system is stressed . . . then the contractions lead to catastrophe, a dead baby, a dying mother. Friday he and Dr. Ammon spent the entire morning in the operating theatre with two complicated cases like this. We can't see most of the collateral damage, the malaria that kills at home, the sickle cell kid that doesn't get transfused in time. But once our first suspect cases tested negative, the Paeds ward started filling back up. We have a child who had surgery for hydrocephalus at a specialized hospital on the other side of the country, and now is experiencing re-accumulation of the fluid in her brain, but can't get back. Collateral damage abounds.

And there is more subtle collateral damage. The many people, especially men here (since women are still doing their unending labor of child care and garden work and cooking and washing) whose ability to earn, to provide, has been suspended. The impotence of that, the frustration, the unknowing, the fear. This hurts. The only mobile people now are the 17-30 year old males who can drive motorcycles. OK there are a few trucks moving goods too. But mostly women have been relegated to foot. This is a collateral message: women stay put, men can move. We saw a CSB teacher teaching a woman to ride a motorcycle yesterday, and that was a little piece of rare empowerment. Then there is the long-standing pain of turning human contact from a basic need to a potential fatality. All cultures need touch, need face to face communication, need gathering. How will we emerge on the other side? 

Where there is collateral damage, there will be collateral grace. That is the basic premise of the universe founded on love: God is at work to bring the fruit from the seed that dies, to bring joy from the tears that fall, and nothing can stop that. In March I happened to pick up Eugene Peterson's Under the Unpredictable Plant, a book about the prophet Jonah that had been impactful for us when we lived in Uganda before and still remained from our library. He talks about the contraction of Jonah's world into the belly of the fish, and how God often uses times of imprisonment, constriction, loss of freedom, for the greatest spiritual work. I think we are being globally disabused of our approach to spirituality as consumers who shop for the latest self-help.

We begin by insisting that askesis (his word for the constricted life) is not a spiritual technology at our beck and call but is rather immersion in an environment in which our capacities are reduced to nothing or nearly nothing and we are at the mercy of God to shape his will in us. . . Suddenly instead of mindlessly and compulsively pursuing an abstraction--success, or money, or happiness--the person is reduced to what is actually there, to the immediately personal--family, geography, body--and begins to live freshly in love and appreciation. The change is a direct consequence of a forced realisation of human limits. Pulled out of the fantasy of a god condition and confined to the reality of the human condition, the person is surprised to be living not a diminished life but a deepened life, not a crippled life but a zestful life. God-intensity begins to replace self-absorption; mature wisdom begins to supplant self-importance.

What if that is our global path in 2020? Facing our limits (YES we are doing that!) and finding depth, mercy, grace, goodness and love. We have a long way to go, but holding lament in one hand for all our sorrowful loss and hope in the other for God's love to still abound, is the only way forward.

empty CSB . . . our staff are still on site, some minor construction projects are ongoing, firewood procurement in hopes of students ever returning . . . we try to visit and encourage our friends with waves from a safe space distance

Saturday morning cappuccinos to lift spirits, also outdoors and #social_space

the little face we see in our door as we return home

trying to comply with science and with policy, a team meeting on our compound, outdoors and spaced

the rules

Rumors went out that we were all leaving on a helicopter yesterday; we walked through town to show we were still in the fight.


Libba said...

Wow wow. Read this aloud to Josh. Great thoughts and perspective. Thank you for letting us enter in, to experience your world..... to find out what is happening there. Mercy. Collateral damage is right. Mercy, Lord.
P.S. the dog face in the door made me giggle to no end. Amazing

Schumpertf said...

Jenifer, Scott, I read your your heart-wrenching words with tears and fond remembrance of my time there. I remember the time during the Rwanda crisis when a friend, Peter, was returned (beheaded) to Nyhuka in the back of a truck; I have a picture of him I took during one of my Bible classes. Then, I read recently that my friend, Kisembo, had died. Every time I returned from Uganda I asked what hope was there for this beautiful, yet deprived, country, and my only confidence was the Gospel, especially that the “new heavens and earth” are ours to look forward to!