The setting sun..

I am sitting in the house listening to the gates clank as the watchmen come to work, and watching a brilliant display of colors as the sun sets for the day. How ordinary, yet extraordinary at the same time?!

I have been here in this place for about 15 months, and the day of my return home for a visit is rapidly approaching. In looking back on the past year, I am so amazed! I see the joys, the challenges, the sorrows, the excitement, the ordinary, the extraordinary, and I wonder how I am supposed to capture all of it and carry it with me.

There is an expected and unexpected component to everyday. For example, I wake up in the morning. That is expected :) I walk to the clinic and see people bathing in the "river". That is expected. I hear gunshots in the night. That is an expected yet unexpected component. You see the cattle are a valuable and coveted commodity, and so it is common to have cattle raids as one tribe attempts to take another tribe's cattle. Our area has been disarmed for the most part, but there is a military presence and there are still some few guns around. When a raid is caught in process, you can almost guarantee gunshots. I go to the clinic Monday through Friday. That is expected. I see wounds that astonish me. That is unexpected. I hear crickets chirping in the night air. That is expected. It rains. That is expected. It doesn't rain. That is unexpected (these days anyhow, soon the dry season will come and rain will be the unexpected component).

How do I capture the life I live? How to I bottle up the last 15 months and carry them home? How do I bottle up the coming two months and bring them back here? How to I live in two worlds that sometimes align and sometimes collide? How do I feel so at home in two very different places?

I don't have answers to all these questions, but one thing I know. I serve a loving God who will carry me through, and these feelings of belonging yet not belonging only make me all the more eager for my heavenly home. I am truly not a citizen of this world. I am a citizen of Heaven!

A chance to fix broken smiles...

This experience occurred a few weeks ago, and I am just now taking time to write about it.

It was time for my second rotation at the hospital, and I wasn't sure what to expect. Students who had been on the medical ward with me warned me that the nurse in charge was strict, but I wasn't convinced that was a bad thing. Nonetheless, I walked in to the surgical ward with mixed feelings. I wasn't sure what to expect. As I walked into the ward my heart sank. This ward already felt worse than the medical ward. The paint on the building was peeling and chipping. The doors were so warped they didn't even close. It felt dark, dreary and dismal as I walked inside. "Lord, give me grace," I prayed. I went in search of the nurses' office, and found it unattended. I looked through the wards and found a nurse who told me to sit in the office and wait for the nurse in charge to arrive. A few minutes later the nurse in charge appeared, and I introduced myself. She told me that she needed to go greet some visitors, but that I should come with her. These visitors were doctors and nurses from other parts of Uganda who had come to do a surgical camp at the hospital. Their mission: to fix broken smiles. They were here to do cleft lip and palate repairs.

I greeted the doctors and nurses, and in the process got an invitation to join them for the week! I was astounded! A week in the operating theatre?! I had been praying for God to give me grace for this new experience, but I had no idea that He was going to give me a completely unexpected experience.

The operating theatre resembled an operating room in the USA, but so different. They strive for sterility, but probably really only accomplish cleanliness. I must say, this cleanliness is a huge improvement over the state of the rest of the hospital though. Thankfully, they do put the patients on antibiotics following surgery so hopefully that helps to cut down on post-op infections.

Here is a break down of things that remind me of the USA:

Large, bright operating lights

Adjustable operating tables

Sterile gloves

Masks and hair nets

The smell: a clean, sterile smell

Things I've never seen in an OR in the USA:

Flies

The use of normal saline to prep the skin

Cloth drapes

Reusing IV fluids with new IV tubing

Oh I am sure there are more, but memories are fading and I can't remember it all.

What an experience! It was so cool to see them work, to assist them, and to just experience an OR in Uganda from a "non-patient" perspective. I'd do it again, and the Doctors said they'd call me next time they're through to come assist! We'll see :) An added bonus: I got tea (soda and chapati) and lunch everyday for free! Incredible!

Imagine this...

Imagine a hospital where the electricity was not dependable. You may expect that hospitals always have power, but not here. Power is an occasional perk. So how does a hospital operate without power? Well, there are no computers to chart treatment on, there are no IV pumps to regulate IV medications, there are no TV’s to entertain the patients, there are luxury hospital beds that adjust at the touch of a button, and there are no alarms to sound to call for your nurse. In fact the most common use for the unpredictable power source is lighting or charging for phones. There isn’t much else in this hospital that uses power on a regular basis. Can you imagine such a place?

Imagine a hospital where there is only one wing out of the several wards in the hospital that offers semi-private rooms. These semi-private rooms are only for those who can afford to pay for their care. Can you imagine privacy being a luxury not a right? The rest of the patients stay in the wards. The wards are divided into a female side and a male side that are separated by a hallway where the nurses’ station or “duty room”, staff toilets, doctors’ room, and an exam room are located. There are 36 beds on each side, and there are several times throughout the week where patients are lying on mats on the floor waiting for a bed. The ward is wide open with little half walls dividing it into sixths. So if you become sick while you are in this place, and you are going to be a patient at this hospital there are a few things you should know. Make sure to bring your attendant (family member) with you to care for you. Also, make sure they bring a mat to sleep on, sheets for you, and money to provide for all your needs. Prepare to lose your dignity, as people are always around, and the privacy screens (for changing clothes or relieving yourself) are few and in high demand.

Imagine a hospital that has very few drugs and supplies. The medicine cart consists of a metal tray on wheels with about 5 or 10 different injectable medications, 8 tins of tablets that may or may not be full, a handful of giving sets, and a few pairs of gloves. If you, the patient, need anything that is not on the cart you must send your attendant to town to buy what you need. You have to buy everything from IV canulas, IV medications, syringes, needles, or anything else you can think of that you might need. Oh, and yes don’t worry these things are available in the local drug stores for anyone to buy. No license needed. No ID needed. No prescription needed.

Can you imagine a hospital like this?! I don’t know if I could have before I came here, but today I get an inside look at this very hospital. An inside look for two months. Oh the adventures we’ll have. Two weeks down. Six weeks to go.

When I wake...

I do not expect to hear people shouting outside my banda. It's true.

This morning, however, I awoke to the unexpected: the watchmen shouting, the dogs running, and quite the ruckus being raised just outside my banda. It was a full moon, so there was some dim lighting in the banda. I saw shadows moving outside, and I heard the noise punctuated with horrific shrieking sounds. Wide awake and curious, I lay in my bed wondering what kind of animal had invaded our compound. I heard the animal shriek, and one of the dogs shriek in response. A few moments later, the noises drifted away, and the shrieking stopped. Heather and I were wide awake now, but there was no what to do. It was 2:30 in the morning, and our watchmen had done their job. We would have to wait a few more hours until morning to find out what had happened. Heather and I speculated about what it could have been, and then eventually fell back to sleep. Our alarms woke us to a much quieter tone and more peaceful environment. Unfortunately it was raining outside, and our poor Ugandan blood was far to cold to get out from under the covers. We finally worked up the courage, got dressed, and headed to the house for breakfast. The watchman came running towards us, and we both wondered "Oh no, did something go terribly wrong in the hunt last night?" We greeted him, and asked if everything was ok. "Yes" He replied, "Everything is fine. Can you assist me with some few matches?" We agreed and asked what they had found last night. "We killed a wild animal." "What wild animal?" I asked. "A wild animal. The enemy of the chickens" He replied. We got the matches, and followed him towards the outdoor kitchen. They drug out the kill for us to see: A badger. We were all happy. The badger had been stopped in his crime: Attacking the chickens. The watchmen had an unexpected breakfast! :)

It isn't every morning you wake up like that!

Sovereignty Sovereignty

The day was unpredictable, but throughout it all one thing was certain: Our God is Sovereign.

You see yesterday Jim arrived back in Nakaale.

Today. We needed a doctor at the clinic.

We had a young man who encountered a snake while biking today. This snake got tangled in his wheels causing him to fall and cut his leg quite badly.

While we were looking at his leg and preparing to clean it, Adiaka ran in telling us there was a critical patient and we needed to come NOW. The mother was crying holding a limp child in her arms. We rushed the child into the office, examined to find the cause of the illness, and tried to get the story out of the frightened mother. The mother had gone to search for firewood, and when she returned she found her child lying motionless on the ground. No matter how many times and how many ways we asked the mother denied that the child had been sick at all prior to this morning. We did our best to stabilize the child, and find the source of the problem. Unfortunately none of our tests showed any abnormalities, but there was definitely something wrong. The best we can tell is that the child must have taken some toxic substance by mouth whether it be alcohol or petrol or what we will never know. We did what we could and then transported them to the district hospital for continued management. Dr. Joseph was there, consulted with us, and agreed that it was most likely some sort of poisoning. They will give the child fluids and provide watchful care tonight.

In between caring for the child and transporting them, we were able to clean, stitch and bandage the wound of the man who had the bicycle accident. He will heal *smiles*

The child is still alive, and I am praising God. I am praying that He will protect this child's life and restore health once again. I am praying for God to protect the other small children left to care for themselves while the adults go about the tasks for the day.

In the beginning, throughout it all, and in the end I am thankful to be a child of the God who is Sovereign.

Lopeyok

When I first met Toto Lopeyok (Momma of Lopeyok) and Lopeyok I never would have guessed that they would be a source of joy and encouragement every week. In fact, my first reaction to these two was quite different. I was angry. Angry that a mother could find a few hundred shillings more important than the life of her son. Angry that her hungry stomach was more important to her than her son's empty stomach. I was grieved that this poor two year old was fighting for life, and his mother wasn't helping him.

You see this Momma showed up with her son one Tuesday wanting to have him admitted to our malnutrition program. He definitely qualified for the program with a MUAC (middle upper arm circumference) around 10 cm, and his height to weight ratio over -3 standard deviations from normal. The looked ill. He was listless, dehydrated and too weak to even sit on his own let alone walk. His tiny limbs were completely unable to support his large belly distended with hunger. Despite the fact that they qualified for the program, and it broke my heart to look at him so sick from hunger we had to call the director of the program to see if we should admit them. Why? This mother and child had been a part of another clinic's program, and the child was not improving because the mother was not giving the plumpinut properly (either selling or eating it herself). As a result she was chased from the program (or discharged is how you say it I guess). The director said to give her another chance, but to warn her that the child MUST improve or she would be discharged once again with no more chances.

Every Tuesday they come to the clinic. For the first few weeks, Lopeyok was sick. One week he had severe pneumonia and was struggling to breath. One week he was dehydrated from a stomach flu. One week he was sick with malaria. And then one week he arrived looking alert, active, and healthy. His belly was still disproportionate to his body, but his arms and legs were getting bigger. He even managed to walk while holding on to his mother's fingers! The weights plotted on his chart keep going up and up! He is still a good couple of kilos away from the target weight, but he is improving. His mother is grateful! Now that probably has a lot to do with the fact that I gave Lopeyok a blanket when he had pneumonia, but still... she greets me every week with a huge smile on her face, and Lopeyok is right there with her smiling at me and shaking my hand when she tells him to greet. That precious smile melts my heart.

So I keep on keeping on with this malnutrition program, and I think of Lopeyok and his mother every time we have to discharge another child as non-respondent to treatment. Every non-responder breaks my heart, but I pray that they will return with renewed vigor to follow the treatment plan like Lopeyok and his mother. I pray that God will protect the little babies with their bellies full of hunger. I pray that our clinic and malnutrition program will show them the One who gives food that satisfies eternally.

Home in Karamoja, At Last

I descended from the plane and was greeted by the smell of Uganda. It is hard to explain, but it is an acrid sort of smoky smell. You know what I am talking about if you have been here. I arrived approximately 12 p.m. Tuesday evening your time (EDT), and 7 a.m. in the morning here. I was so excited to be here. Traveling seemed to last forever, and it made it all the longer since I was stuck in the Airport FOREVER (awake the whole time) and then couldn’t sleep on my second flight. Oh well, there is no what to do. I waited for a while in line to get my visa, and then headed to collect my baggage. It was very easy to spot my luggage since I was almost the last person through to collect luggage, Walking through the doors with my luggage secured I saw a familiar Mzungu face, two of them actually. Pastor Al and James were there to fetch me. I couldn’t have been more thrilled to see smiling and familiar faces (I had a few to many hours on my own).

Wednesday (the day I arrived here) we ran various errands in Kampala, and then head back to the airport, checked in at the flight motel, and relaxed for a bit. The T’s went to fetch Laurie (Mrs. T) from the airport later on that evening, and I stayed back and got ready for bed.

Today the T’s and I ran a few more errands on the way out of town and then headed to a city about two hours from the capital. We met up with Dr. Jim and Jacob there, transferred my things to the other car, and then went our separate ways. The T’s are taking a few days of R and R and I headed to my new home. It is so good to be here, and start settling in. We didn’t get in until just before dinner time, so we unloaded, cleaned up and ate dinner with the Eldeens. Kris and I talked for a few hours after dinner which was really nice.

Thank you all for your prayers. I am so happy to be back. To be settling into the place I will call home for the next year. Don’t forget to keep in touch.

*tick, tock*

Time is passing by, and it has taken summer with it. My departure for Uganda is just around the corner. I think I started counting the days a little over 2 weeks ago, and now I am suddenly realizing that I only have a little over 2 days before I board the plane! Where has the time gone? Whoops... I have only saved approximately 1,000 things to be done in these last few days :) I wish I could have fit more in the past two weeks, the past month, but even so the days have been full. Unfortunately, I do feel as if there are 1,000 things to do and hundreds of people to see and I know that it won't all happen.

To my dear friends and supporters, thank you for your love, prayers and financial support. I am sorry I haven't been able to spend quality time with each and everyone of you, but please accept my heartfelt gratitude. It is through you all that God has provided for all my financial needs for the upcoming year. I know that God will continue to provide for my needs physically, spiritually and emotionally throughout the next year. I am excited to see how He will provide, and I know at times He will use you all in new and special ways to encourage and strengthen me. Please don't underestimate the power you have in this endeavor through prayers and thoughtful emails or cards.

This leaving part has never been easy, but I have also never left my home for a year. It is hard (as many of you warned me), but I know without a doubt that this is God's will for me at this time. Oh how I wish I could gather all my friends and family in one place instead of this loving of multiple people in multiple places, this separation for a time, and all of these good-byes, but I can't. Not for now. However, I know that a time is coming when all those who are in Christ will be joined together, in one place, for eternity! Praise God!

So I guess this post can be summed up by: This leaving and preparation is hard, and I love you all. In the midst of this "hardship", let us look forward with great joy to the day we will all be joined in the throne room of our King!

Returning...

It was a hot day, the road was dusty, and my feet were tired from working at the clinic. Lunch of rice and beans was a welcome resting point. As I ate my lunch, I reflected on all the things I had seen since I arrived in Uganda. Breaking into my thoughts, Kris Eldeen, asked what my plans were after graduation. I told her how I was hoping to get more experience in pediatric nursing. She invited me to consider coming back to Uganda after graduation to work in the clinic. 

I arrived home after my time in Uganda praying and seeking counsel about the possibility of returning to serve God in Uganda. Through the counsel of my parents, pastor and members of the mission board and exploring the possibility further, it has become clear that God is calling me to Uganda for the coming year.

I would like to invite you to partner with me in my mission to Uganda.  I will be leaving on August 24, 2009 to spend one year in Uganda working with a team of missionaries ministering to the Karimojong people.  I need to raise $9,000 to cover the cost of supplies, travel, insurance, and living expenses.  Would you pray and ask God how He would have you be involved with this mission? If you would like to partner in this mission financially please leave your name and email address in a comment. 

Thank you for prayerfully considering how you can partner in this mission endeavor. 

                                                     

Leaving on a Jet Plane

Well... departure is just around the corner. I am leaving tomorrow at 12:15 from Indy to fly to D.C. to meet up with the rest of my team. We will hang out Monday and Tuesday, and then head to the airport Tuesday evening to begin our adventures! We will travel for 30+ hours and then finally arrive in Uganda. We will spend the night in the capital city, and then head for our final destination. Please pray that we would have safety in traveling. Pray also that the roads in Uganda would be passable. The roads to the mission compound are dirt, and the rainy season has started.
I am praising God for abundantly and graciously providing all the funds for our trip. Your generous gifts have made it possible for me to have this amazing opportunity, and I cannot thank you enough. Seeing the Lord answer prayer by providing for all of my needs from finances to luggage has been so encouraging and humbling. I am very excited to see how He will continue to glorify Himself through our trip.
We hope to have internet access while we are there, but it is still uncertain. I am hoping to be able to keep you all updated either here or through email. If for some reason the internet access does not work out, I am sure I will have plenty of stories to tell when we return on July 16th.

An electronic letter

This is a copy of the first letter that I sent out about my upcoming mission to Karamoja, Uganda for those of you who didn't get a copy.

Dear Friends and Family,

Greetings! Summer is rapidly approaching, and I am excited to share with you some of the things God is doing in my life.

Currently I am in my junior year at the IU School of Nursing in Indianapolis. In looking back on the past year God has used change, academic challenges, and His word especially through sermons and bible studies to teach me and mold me.

I was praying and thinking about how to use my “last” summer break when a couple of opportunities opened up. Through the counsel of my parents and others I have decided to pursue a summer missions trip to Uganda with Reformed Presbyterian Missions. Some of you may remember my previous summer mission trips to Cyprus in 2005 and 2006 with RP Missions. This summer I am excited to participate with RP Missions in another location. This mission will allow me to use my nursing skills to serve in a clinic and gain experience in rural medicine. I am praying that God will use this experience to show me how I can use nursing to serve Him at home and abroad.

I will, Lord-willing, be traveling with a team of six others from June 9 to July 15 to work with a group of Orthodox Presbyterian missionaries in the Karamoja region of Uganda. Karamoja is rural sub-region in northeastern Uganda. The missionaries are using education, training in sustenance farming, medical services and other practical methods to minister to the Karamojong. Our team will be helping the missionaries in whatever ways we can whether it be manual labor, helping in the clinic, or teaching Religious Education and English classes in the village schools.

I am excited about this opportunity, but I also recognize that it will challenge me in many ways. I am writing this letter to ask you to consider supporting me in this mission. The trip does have a financial cost of $3,400 to cover flight, food, supplies, etc., and if you are willing and able to support me financially I am enclosing a response card and envelope. Most importantly, my teammates and I need your support in prayer as we prepare for and participate in this mission.

A few specific things you can pray for me and my teammates would be:

- That each member of the team would be getting daily time in the Word

- That God would protect us both in preperation and while we are there

- That God would provide for our financial needs

Thank you! I look forward to being able to share how God used our mission trip in Uganda.

Sincerely,

Jenny B