Life Down the Rutted Red Road

Category: The ruts

White Tarps in the Wilderness

What is that? I saw a flash of white amongst the burnt ground, brown scrub, and occasional green bush as we bounced along the red dirt road. More squares of white appeared and I realised they were the UNHCR issued white tarpaulins. We must have reached one of the many refugee camps now spread out over northern Uganda, seeking to provide for the 700,000 South Sudanese who have come over the border in the last year seeking refuge.

As we went past, I saw a sprawl of mud houses with grass or tarp roofs, with the occasional collections of metal shacks and stalls selling produce. Youths lounged outside these on their motorbikes while children weaved through them chasing bike tires with sticks. We passed water points with lines of plastic yellow jerrycans snaking out around them, waiting for the child in front to finishing pumping the spigot or for the water delivery truck to come. As the afternoon progressed, I saw older children in school uniforms walking steadily along the dirt paths joining the huts, many knowing they would have to wake up tomorrow early to make the two and half hour walk again to school. There were some adults using hoes to break up the ground, hoping to cultivate something to supplement the flour, oil and beans they are issued with, but around many of the huts it was just barren ground. The rains are late this year. Soon this land will be desert, my host commented.

——–

In another desert, the relentless sun of the Sinai Peninsula bet down on the people as they shuffled forward, the occasional breeze only lifting more dust into their faces. It was forty-five days since they had escaped from their homes of suffering. But the initial jubilation and relief had been chased away by the rumbling of their bellies. Maybe they should have stayed with the hardship they knew rather than watch their children get weaker and weaker in this vast and dreadful desert. Why was Yahweh leading them into such a hard place? How could they think to worship him under these conditions?

And then, one morning there were thin white flakes like frost on the ground around their tents. What is that? The report passed from family to family: it is bread for us to eat and we are to gather just what we need to eat for today. The next day they went out and there it was again. Day after day in the foreboding wilderness, they went out and there was the white stuff, and they gathered and they ate.

———

I do not like to be dependent. I would much prefer to think that I can handle what gets thrown at me. That I can solve the problems. That I do not need to bother anyone else. Sure, I can profess that I depend on God for everything, but I would much prefer for that to stay in the realm of theory rather than experiential reality.

I would not choose to live in a wilderness. I prefer comfort, temperatures where I am not covered in sweat all the time, water trickling amidst lush green bush, fertile land that I know will be able to feed my family.

The reality of dependence though affronts me in the camp. People standing in queues for hours to receive their rations for the month. Mothers with their babies strapped to their backs and their children hiding behind them, turning up with just what they could carry on the five day walk to safety. My university-educated colleague sitting outside his rough mud and stick house, shameful that he has nothing to offer me in hospitality other than a cup of water.

But, I cannot help but be grateful for this wilderness. If this land had not been harsh, it would have been already intensely cultivated by the industrious locals. Yet because it was so barren, it has provided a place for my friends to find refuge.

We are praying hard said one of the men as we stood waiting for the vehicle to take me away from the refugee camp.

White tarps flap in the wind. Banners of dependence. Banners of mercy and provision.

Though I am leaving this patch of wilderness, I am reminded that I too need these.

May 1, 2017
And the fireflies danced in the darkness

I was called over to hospital at 0430 the other morning. It is never a good thing if they are calling me at that time.

It was for a premature baby, a two day old boy that had been born elsewhere and then brought to us at a few hours of age. We had followed our normal protocols and commenced him on our full treatment. Yet, by the time I arrived in the early hours of that morning, his colour was grey and he was not moving. The nurse who called me had been trying to resuscitate him. We tried again together, in the view of the child with sickle cell on oxygen, and the mother of our other premature baby who was nearly ready for discharge after five weeks with us and the grandmother watching over the unconscious six year old with cerebral malaria. We tried for several minutes, but there was no heartbeat and no breathing.

Huwo kalaas. He is finished, we explained to the family. Our treatment had not been enough and there was nothing more we could do.

We removed the medical paraphernalia and wrapped up the baby. The ward settled back down to get some rest and I headed back to my house.

And, as I walked the well-worn path the fireflies danced around me in the grass, winking light into the darkness.

———–

I have been reading through the book of Exodus. It is a book about God who sees the suffering of his people. Oh God, see these people around me and their suffering. About God who acted mightily to rescue his people. Oh that you would use your power to restore this situation and rescue your people. About the God who revealed himself to his people. I do want to know you more. The God who called Moses to enter the thick darkness to meet with him. Ah what? Darkness!

Darkness is the hours listening to the gunshots wondering if death is going to come for someone tonight. Darkness is watching the child’s laboured breathing and not knowing if she will make it through the night. Darkness is listening to the creak of the bush and the rustle of leaves, knowing there is danger out there but being unable to see it. Darkness is not knowing if we will be forced to leave this week or if there is a future for us in this place. Darkness is when the torch has broken and the moon is hiding and we cannot find the path.

Yet, sometimes we are called to enter into the darkness. And, it is in the midst of darkness that we see the flash of the firefly.

————-

This place reminds me of the many things I cannot do. Despite my best efforts, I cannot keep track of every little detail of patient care and make sure nothing slips through the gaps. I cannot make a baby breathe. I cannot bring back to life those who have passed. I cannot listen to every story of suffering. I cannot chase away all the fear. I cannot stop the fighting. I cannot bring peace.

But, I am not meant to be enough. I am not meant to be the sun that shines in the day.

But maybe, as we wait for the dawn, I can join the dance of the fireflies in the darkness.

October 11, 2016
On red first aid kits and living in a bubble

The other day the hospital received a kindly give us request for some supplies. Some people were going to be travelling to the border. Due to who was travelling and where they were travelling, there was a reasonable likelihood of casualties.

Kindly give us. Hmm. For the sake of diplomacy (and I suppose the lives of the people) we should give something.

Gauze? Nope, we have only got a few packets, and that needs to be rationed for our C-sections. Morphine? It is not available in the country, as far as I am aware. Fluids? Okay, maybe we can spare a box. And, I suppose, I better throw in some IV lines and tape for securing as well. What else? First Aid Kits!

Ok, I know that first aid kits are not what are normally stocked in a hospital. But sitting in the back of our blue metal shipping container (which is our dumping ground for all the things people have generously donated to us but for which I have not yet had the time to stare at with squinted eyes and a head at just the right angle until I can work out what use I could possibly have for them) is some boxes of first aid kits. Perfect!

I pulled them out. The cardboard boxes were a little termite eaten, but the shiny red kits themselves were still safely ensconced in their protective plastic wrapping.

On peaking inside I was pleasantly surprised. They were pretty decent kits. They had bandages, scissors, gauze, bandaids and even some antiseptic wipes. Definitely fancier do-dads than anything you can get around here. I could not even find any obvious expiry dates. (Because, you know, expired things are very dangerous).

And, so we answered the request with a couple of boxes of first aid kits, along with the IV fluids and a couple of doses of pain medicine.

The likelihood of a first aid kit that you normally have in your car in case your kid falls over and scratches his knee actually being much use for bullet wounds is not particularly high. There are also bad roads, limited supplies in the government hospital, which is the official trauma centre, and the pharmacies are now shut or out of stock. So, if someone gets badly injured their chances are not particularly good.

But, at least the vehicles will have first aid kits.

Sometimes I feel like one of those shiny red first aid kits. I am donated from the West, with fancier do-dads than anything around here and not obviously expired on the outside (though I currently do not have much of a mirror to tell otherwise). But, in reality, how useful am I when the country is falling to pieces, when hospitals have no staff or equipment, when people are starving because they are hiding in the bush and there is no food in the market because it is too dangerous to bring in supplies.

But does it matter how useful I am? Is it simply more important that I am present?

Yet, there are varying degrees of being present. For the first month after fighting broke out I did not leave the compound that contains my house and hospital, and since then I have only left a couple of times. So though I have heard some of the rumours that are swirling around, the main things I hear are the sounds of the insects and the chickens and the children playing. Although the food is a bit plainer I have never gone hungry. Although I see the fear in the huddled staff conversations and in the patients begging for early discharge so they can escape somewhere, I have felt safe. And, in the evening after work, I can download a book and get lost in someone else’s adventure.

I live in a bubble. A red first aid kit with a plastic bag covering it bubble. Does that count as being with?

Yet, it is because of this bubble that I am able to continue serving. Because I have known security, I can listen to staff member’s fears and worries without being overwhelmed by them. Because I am able to eat and sleep in my own bed, rather than the bush, I have the energy to deal with the demands each day. Because I can still know the joy of curling up with a book, the despair and darkness does not consume my soul.

Is this bubble what I dreamed of when I thought of incarnational mission? No. Is being a first aid kit how I envisioned changing the world, or at least my little corner of it? Surely, I could be upgraded to a decent trauma kit. But, is this bubble a gift from the Father? Most definitely! Is this opportunity to serve in his strength and grace a privilege and joy? Yep.

So here’s to being a red first aid kit and life in a bubble.

September 1, 2016
Butterflies and Bullets

I read an article a few weeks ago celebrating that New Zealand had been named the 4^th safest country in the world. Not really surprising in my biased view. However, the article also listed the 5 most dangerous countries. South Sudan came in at number two, surrounded by Syria, Iraq, Afghanistan and Somalia. Surely not this country where I wake up in the morning to the sound of the chickens scratching in the dirt, the children singing in the distance and the neighbours calling out greetings as they walk to their plots of land. Surely not in this place where I walk into town, stopping a dozen times to shake hands with the kids who run out to greet me, where I haggle about the price of cloth I want to buy and laugh at the marriage proposals and greet some ex-patient whom I cannot remember but who knows my name. This place, my home: more dangerous than Afghanistan and Iraq and Somalia? Countries that are synonymous in my mind with security escorts and bombs and terror and anarchy and fear. Surely not!

Ok, so we have not been able to travel by road recently to Uganda due to bandits along the road. And a good proportion of our staff members have lost a family member in fighting over the last couple of years. And a teammate has not been able go to his farm 30 miles down the road due to insecurity there. And we did receive patients that had fled into the bush from fighting 50 miles away in the other direction.

But still –worse than Iraq?

But, then it was the 5^th independence day of South Sudan. And troops in Juba started fighting each other. Again. And a small skirmish became hundreds of people dead. And staff members on leave in Juba were ringing us telling about being unable to get food or water while the bullets and bigger killing instruments flew around them.

And though the bullets arching through Juba’s skies did not reach the 100 miles to here, the fear has. The paths have become full with people walking with their possessions bundled into plastic basins on their heads. Heading to the bush. Heading to the village. Heading to Uganda. Searching for safety, for where the fear will not hold them.

Hate has broken out as well. Fighting elsewhere has provided the excuse to take out that neighbour from that tribe, who did such and such last year. Or at least to keep the shop shut so that that tribe cannot buy any food and hunger will bite even harder than before.

And the despair starts reaching in, even to those who do not flee. What hope is there for this country? Will this baby taking their first gasp in my hands today ever get to live in a place where they know peace? Or will they too grow up knowing what it means to run to the bush as the rumours fly and people with guns loot and the rumble in the distance could be a bomb instead of thunder.

Yet, as I sit and ponder, butterflies dance in the breeze as my passionfruit ripens on the vine to the sound of children playing in the dirt. Is this just a mirage?

How do I describe this country of my heart? What reality, the butterflies or the bullets, do I let be my story? Or is reality not one or the other, but both. The intricate pattern of a butterfly wing can exist in the midst of brokenness. Fear can empty a town and yet there is one who says “Do not fear”. There is evil, and oh such evil, but there is still an 810 gram baby blinking out from under the blankets in our ward.

And the darkness will not triumph in the end.

July 20, 2016
Shukran

As I did my usual morning visual scan of the paediatric ward a tall woman draped in a purple gauzy shawl called out to me “Shukran. Shukran. Thank you. Thank you.”

I recognised her from the previous day. They must have graduated up from a mattress on the floor in the procedure-come-overflow room to the ward.

But, other than the change of location, at a quick glance I could not work out why she was thanking me. Her two year old son appeared to still be unconscious and he still had oxygen on at the highest level, a nasogastric tube and intravenous fluids. That is the extent of our interventions and if a child has all three of these it generally indicates that he should be in an ICU, if we had one. Here though he was one of 23 patients (and 30 other patient relatives) cared for by two nurses overnight.

I tried to explain to the mother that her son was still very sick. But she still thanked me. “He breathes. He is not hot. He is not seizing”. True.

I had heard the wails in the early hours of the morning from my bed. As I had listened I thought that it was most likely him who had passed. He had presented 48 hours earlier with cerebral malaria. Despite having completed three doses of our strongest anti-malarial he had still seized the day before for over an hour, as his mother wailed on the floor. When the seizure finally finished he was choking and gasping for breath, because of the water they had been pouring into his mouth when I was not watching. Throughout the day his lungs sounded terrible and he still did not regain consciousness. His grandfather and then his grandmother spent the day holding him in their arms as they tried to balance on the mattress on the floor. I had spent quite a bit of time with him over the day trying to think if there was anything else we could do. And there was not.

So, I had thought the wails were for him. But, they were for another child, another child for whom the malaria had been too strong for their body. Why was he still alive this morning and not the other six children who had died from malaria during his admission?

And, I do not know. He had definitely been sick enough to die. We did not do anything different from our normal. This has been a very bad malaria season and having to wrap up yet another body has at times felt like the pervasive theme.

But his mother reminded me of the need for gratitude. In the midst of the wails at night, the daily struggle to find enough mattresses and beds for sick kids, the worry that we will run out of anti-malarials, the tired and stretched staff, the frustration with the things that we cannot do; will I choose to be grateful?

Yes, there is so much pain and brokenness. Yes, there is a long way to go in recovery. But, he breathes.

May 26, 2016
Things for which there is no medicine

Today, a little boy died. He had been sick for the last few days, but he and his family had been hiding in the bush due to fighting near their home. Finally yesterday, he was able to get to a health clinic. The health clinic referred him to us, along with his mother who was in early labour with her 9th child.

By the time he reached us his tongue was white with lack of blood, malaria parasites swarmed in his blood, his hands and feet were puffy due to malnourishment and he was gasping for breath. We gave him a couple of blood transfusions, our strongest antimalarials, oxygen and other fluids and treatment: everything we could possibly do.

But today he still died.

While he was dying, his mother lay in a bed in the adjoining ward. We performed a C-section on her early this morning as her baby was lying sideways. She lost a lot of blood but she and her new son should do okay. The relatives have not told her yet that her other son has died. They told us they are afraid her wound will break open if they tell her now.

The other day I heard the English word “impossible” translated into Juba Arabic as “something for which there is no medicine”.

There seems to be a lot of that around.

Our medicine was not strong enough for this little boy to live. And once his heart had stopped beating there was no medicine that could bring him back. There is no medicine that will stop this mother’s heart breaking, even if we can stop her abdomen from doing so. There is no medicine that can make the fighting stop and enable people to return to their homes and live life.

And I hate it.

I like nice tidy diagnoses for which you can give just the right medicine and then the patient is cured. I like being able to see an issue and be able to do exactly what is needed to resolve. I like happy endings where everything is tied up neatly together.

But, that is not our world. Our world is full of impossibilities; of pharmacies that do not have the right medicines for our particular ailments.

But, thankfully, this world where two year old boys die because they could not get to a clinic because of fighting between different tribes is not our only reality.

This world was created with limits, it was allowed to stay broken in need of medicine, so that we would long for the day when the broken will be gloriously repaired, so that we would seek out the medicine that we desperately need, so that we would marvel at the one for whom nothing is too difficult.

September 17, 2015
Beauty

The log had termite holes in it. But I sat on it anyway, hoping that the termites chose not to return for a few minutes. From that angle all I could see were fields growing our food, a cloud streaked sky, birds playing in a tree. The insect chatter drowned out the distant generator drone.

It was peaceful.

It was beautiful.

And yet, in a building only 100 metres away, I had held three dying or dead babies over the previous 48 hours. I had explained to their mothers that there was nothing more we could do. I had removed medical paraphernalia from their bodies and wrapped them in their cloths so the families could take them home to bury them.

And beauty seemed far away.

Brokenness reigned.

In this country there is so much pain and loss and hurt and hate and frustration and evil and sickness and death. Sometimes it makes me want to shake someone, or, if I truly be honest, shake my fist at God. At other times in seems easier to hide in some other fantasy world where war does not reign, where babies do not die, where I or another author can control the world and create that happy ending. And then there are the days I just want to give up: “If you want to destroy yourselves, go ahead…”

Yet, as I sat on that termite eaten log I thought about this beauty and this brokenness. And I realised how many times I had been sucked into the brokenness and the never-ending “battle” against it that I had not paused to look at beauty. Is it not just a frivolous thing anyway, this beauty? What are sunsets, birds swooping in the sky and wild-flowers in the grass compared to saving lives?

But, if I do not see the beauty, the brokenness wins. It becomes the only story of this place, of this country, of this world. But the Creator, when he banished Adam and Eve from the Garden, did not banish all beauty from the world. Instead he allowed it to co-exist. Allowed it to be slivers of his glory. To proclaim that this brokenness is not the end story. It is not the total picture.

One day beauty – and all that is good and true and wonderful – will win. It will be the story.

And so today and tomorrow and next tomorrow, between the dramas and the pain and the babies dying and the heartache of this place, I will try and search for beauty. To open my eyes to those slivers of glory. To pause to gaze at a sunrise. To sit on a termite eaten log and choose to delight.

August 7, 2015