birth

I don't really know what I'm setting out to say here, but I've been thinking about the Christmas story from a different angle recently. But let me backtrack...

I finished working at the hospital last week, spending my last 5 days in the labor ward. This was probably my favorite place because the labor ward is the one place in a hospital people come for a usually happy occasion versus having an unexpected tragedy or sickness. 

In certain situations it's almost comical how not-shy I am, meaning I found myself giving laboring mamas backrubs and advice, directed nursing students with jobs to do, and delivered 3 babies (something that was on my life list of things to do). I've seen and participated in births before but being the one who facilitates the passage from one reality to the next for a new baby's life is breathtaking. 

You've probably heard it said that birth is beautiful. Yes, birth is beautiful....but not particularly pretty. It involves hard work, pain, and oh-so-many different body fluids in plenty. 

 I loved watching the midwives because they have more autonomy than most nurses here and it gives them a confidence in the way they work. When they examine their gravid patient it's as if the big belly becomes their canvas they will work a masterpiece upon... Slowly rubbing their hands together first to banish cold fingers, then methodically and purposefully massaging, pressing, and feeling that belly to divine a baby head, back, rump...  These midwives don't have tocodynamometers or bedside ultrasounds. Their sole tool is a tin cone - one side is put against the pregnant belly while the midwife presses her ear against the other side to hear the "Thump-thump-Thump-thump-Thump-thump" of a yet unborn, quickly beating heart. 

The miracle of life, indeed. Watching babies delivered here in Uganda was both fascinating and scary not necessarily because of what they do, but because I know what they lack, as compared to the American labor and delivery process. These midwives seem to go in almost empty handed when you consider the plethora of complications that "could" happen. I had to remind myself several times that I'm a staunch supporter of "natural" childbirth and that women have been having babies for centuries.....which brings me back to where I started - Christmas, the birth of baby Jesus.

I've heard that Mary was probably only in her teens. I'm just trying to imagine what it must have been like for her - dealing with the severe body-image disturbances of pregnancy when she hadn't even really reached womanhood yet. As if that was not enough, she was away from home in a dirty place meant for animals. Who helped her when the moment to deliver came? As far as I can tell the Bible doesn't mention anyone else besides Mary and Joseph...and most expectant fathers I've come across aren't exactly the picture of composure, let alone ready to take the position of midwife. 

I don't really have new or profound thoughts here, I'm just thinking out loud...It's just that I find it equally breathtaking that God would choose to have his Son BORN - to enter the world in a potentially perilous and undeniably messy process - that to me is a divine miracle and mystery. 

Luke 2: ⁴So Joseph also went up from the town of Nazareth in Galilee to Judea, to Bethlehem the town of David, because he belonged to the house and line of David. ⁵He went there to register with Mary, who was pledged to be married to him and was expecting a child. ⁶While they were there, the time came for the baby to be born, ⁷and she gave birth to her firstborn, a son. She wrapped him in cloths and placed him in a manger, because there was no room for them in the inn.

The Acculturation Project

I think it’s a pretty simplistic and innocent idea at the surface, one that is ingrained in us at an early age and maintained throughout our lifetime. You know, conversations like these:

“Well you are such a pretty little girl. What do you want to be when you grow up?"  

                 “A ballerina.”

“Jimmy, what do you want to be when you grow 

up?"                     

                  “A fireman.”

“Wow, look at this report card. You are so smart. I bet you’ll be the president of the United States when you grow up.”

These dialogues don’t end when we stop dreaming of pink tutus and red fire engines either. I mean, isn’t that a main driving force of life, this question, “what will I do?” We teach our children their ABC’s so that they will go to high school, so that they can study hard and get good grades, so that they can get into an Ivy League school, so that they earn a degree that will assure them a fulfilling, successful, and lucrative career… right? Maybe that is a bit extremist, but I know that in my own life I often fall into the pattern of thinking ahead to “the next thing” that I will do, whether it be career, job location, education, etc.

We are a resume society thoroughly invested in impressing others so that we can get to the next step where happiness is sure to be waiting for us. I mean, be honest, would you rather say “I’m the chief cardiothoracic surgeon at John Hopkins Hospital” or “I’m the manager at Burger King down on 1^st Street”?

For all the striving we do for it, here’s the funny thing about vocation – it doesn’t cause true and lasting happiness. I think you can enjoy your job. I think you can find a sense worth or fulfillment in what you do. But no matter what you do, no matter how much education you have or how many letters you have after your name, you will always have bad days when you wish you could be someone else doing something else. In college we change majors (multiple times). After college (and loans) we change jobs and whole careers because it’s not what we thought it would be.

I’m not all negativity. I think America is what it is today because people have continued to push themselves mentally and physically. It’s why we have things like the Olympics and the Nobel Peace Prize.

I’d like to tell you a story, one of the reasons I’m writing this in the first place.

The last month or so I’ve been working on getting a permanent Ugandan nursing license so that I can be legal and ethical doing my job here. In order to obtain a license I was told that I had to work in a Ugandan hospital for 8 weeks, 8-5, M – F, so that I could gain understanding of the Ugandan healthcare system and healthcare issues. After some finagling and games of “I know so-in-so,” my “sentence” was reduced to 4 weeks, for the hours of 9-3.

I now call this time “The Acculturation Project.” Here’s the truth though. I have not had a good attitude about this time in general because (1) I don’t like being told what to do, (2) I feel uncomfortable with mandatory volunteer work, and (3) I felt that I would have little to learn from the healthcare system of Uganda.

Last week was sad for me. It was week 3 of 4 and it was spent in the pediatrics ward. I’ve never had a desire to work pediatrics mostly because I love kids so much it’s hard for me to see them sick and hurting. Put in this context where I feel essentially powerless is painful.

The nurses on this ward either didn’t know what to do with me or didn’t care, so my time was largely self-directed. I made daily rounds with the doctors and I don’t think they knew what to think either as I followed them around, looked, listened, asked questions, made comments and oh-so-subtle suggestions.

Since I had so much free time I introduced myself to the patients, I made friends with the mothers (who gave me curious looks of “what is this white girl doing?”), and I invariably ended up having favorites.

The people I met and stories I heard gripped me: HIV-positive mother with HIV-positive and Tuberculosis-positive son; small baby with a likely fatal brain injury; children with burns; small baby girl with a life-threatening heart condition…These would be tragedies enough seen in the US where care and resources are almost limitless, but here, where there are no NICU’s, or ventilators, or anesthesiologists them seem needlessly cruel. I’m used to seeing bad, even horrible things after 3 years of working in a trauma ER; I’m not used to seeing bad things without having the resources needed to fix them. The sad truth is the week before, I spent some time taking pregnancy histories from women in the antenatal clinic and almost all women with previous pregnancies have had babies that died. Death is an accepted part of life.

In the midst of these stories, I met Richard. Richard is a 6-month old boy who was in the hospital for malnutrition that had reached a stage called Marasmus (meaning the child reaches a point of emaciation and wasting from protein-energy malnutrition). The first time I saw him he looked up and gave me the biggest laughing smile, as if he didn’t have a care in the world.  What a personality.

Let me explain how hospitals here work; nurses are responsible for giving out medications and administering treatments, but their responsibility ends there. Families are expected to stay with the patient to attend to any patient care needs – like providing food, helping with toileting, providing and changing sheets and clothing, etc.

Richard’s mother was, essentially, absent. The other mothers told me she was probably “out getting food.” I never saw her the first few days I was there. So, I began changing his diapers, holding him, taking him around to “visit” with other kids. Pretty soon all the mothers in the ward knew Richard by name and that he was my special friend.

The last day in the ward was really difficult. Richard was supposed to be discharged, sent home with his mother who would have education and a referral for a follow-up clinic. I was angry. Richard’s mother, it turns out, is a nicely plump woman. I can only hope Richard’s future will be brighter and more full of love than his past has been.

So, how do you say goodbye? I thought about not; I thought about picking him up and walking out the door.  In the end, I told him I loved him. I prayed over him, "The Lord bless you and keep you--the Lord make His face shine upon you, and be gracious to you…”

Most of my thoughts during the week were consumed with thinking about going to medical school and how much more I could help these kids if I did…When the week was over though, the things of true substance did not involve life-saving medical heroics. The only thing that mattered was that I sat and talked with people, I changed diapers, I learned names and remembered them, I held babies and gave them love, I held a hand.

I’m not telling you this story so that you can think I am some sort of a saint, because I’m not. I’m telling you this because I was wrong and I need to constantly redirect my thinking.

Have I strayed too far from where I began? Here’s my point. I spend far too much time worrying about what I should accomplish and what I want to do, rather than focusing on the type of person I want to be.

 

“[They] don’t accomplish what they wanted to accomplish because they weren’t the people they needed to be…God is more concerned about changing you than your circumstances. It could be God wants to keep you in these difficult circumstances cause He’s changing you." 

                        - Francis Chan

 

I still want to be intelligent, talented, and challenged in my career. I will still dream about things I want to do in the future. But more than that, I want to be a woman of excellence and I want my life to be characterized by love.

 

 

“We can do no great things, only small things with great love.”

                    -  Mother Teresa

 

“For this very reason, make every effort to add to your faith goodness; and to goodness, knowledge; and to knowledge, self-control; and to self-control, perseverance; and to perseverance, godliness; and to godliness, brotherly kindness; and to brotherly kindness, love. For if you possess these qualities in increasing measure, they will keep you from being ineffective and unproductive in your knowledge of our Lord Jesus Christ.”

                            1 Peter 1:5-8

 

bus stop

A friend and I took this unconventional vacation to Belize last year. I say it was unconventional because although the original plan was to soak up the sun in Mexico, the wind of adventure took us some 12 hours on public transportation to a small fishing village in Belize. It was unconventional because it involved fleas, Rastafarians, more rain than sun, many unplanned days, lots of walking, and lots of waiting.

I have strangely fond memory. We had gone hiking and were ready to catch our public bus back to town. It turns out bus schedules were really only guidelines for a more "relaxed" rule of operation; in the end we waited for our bus for a good 3-4 hours on a semi-deserted highway road (through a rainstorm I might add). 

I learned that much can be said for waiting, watching, and observing. Small details of everyday lives of everyday people suddenly become intriguing;  you meet people who are unusual and outside of your ordinary; you allow your mind to wander and wonder with questions, realities, and possibilities. 

But WAITING....waiting....waiting, is hard. 

It's been on my mind recently, this waiting, probably because it's something I dislike and something I am not good at doing.

I've smacked into this wall called waiting several times since being in Uganda. The culture here is relationship-driven which is interpersonally rich....and functionally slow. Everything takes longer. 

But WAITING....waiting....waiting, is shockingly common. 

I get this "woe-is-me" tendency when things do not go according to my timeline for me. If I dare to turn my head even slightly to look around though, I see waiting happening to everyone. 

So what's the point? Is the value in the waiting itself, or in what comes when it ends, or in what it takes to get through it? 

But WAITING....waiting....waiting, is necessary.

I wonder what kind of a person I would be if my every whim was instantly gratified? The words that come to mind are less than complimentary - selfish, greedy, proud, isolated...

Do we have a choice when it comes to waiting? I'm most certainly first in line when it comes to being proactive, but what about those things outside our realm of control? I suppose the alternatives would be to Give up Hope, or Go Elsewhere. And isn't that just it, that waiting for the time, or the event, the thing, or the person involves that shiny treasure called HOPE? Waiting requires one to have hope and is rewarded by hope for the next time...

I often feel like I have a scattered soul. Like I need 13 lives to do all the things I dream about doing. Like each dream is so distantly far off or unrelated that there is no way it will ever intersect with reality. 

So now what? Do I embrace the "Just do It" philosophy or do I do as John Mayer sings and just wait for the world to change? I don't want to drown in passivity but I don't want to be made ugly by self-sufficiency either. The balance is tricky.

My need for Hope, whether waiting or doing, however does not change....and my Hope is unchanged and unlimited because it is rooted in God, who remains constant and everlasting throughout. 

Is it just coincidence that a new and dear friend of mine here gave me my own Ugandan name, "Ssubi"...."Hope."

"And hope does not disappoint us, because God has poured out his love into our hearts by the Holy Spirit, whom he has given us." Romans 5:5

Live (well, almost) from Uganda....

demonstration

I live in a small grandmother’s house behind our main house. Outside my door is a tall cement wall topped with loops of barbed wire separating our peaceful compound oasis from the rest of the noisy neighborhood.

I don’t know my neighbors. I know that they have a cow (that wakes me up mooing most mornings), I know that they have a baby (that cries loudly most nights), I know that they like music (that plays from the radio almost all the time), I know that they use a fire to cook (that wafts smoke over the wall and makes me sneeze), I know that they are a part of a community (that is interactive and talkative judging by the conversations in Luganda that I hear but can’t understand); I know these things about them, but I don’t know them.

I’ve been reading a book called “We wish to inform you that tomorrow we will be killed with our families,” a book that chronicles stories from survivors of the Rwandan genocide. I’ve always been interested in these types of books, yet somehow it is easier to read them now, being in Africa. It’s as if saying, “Hey, this happened in the country that I could drive to in a matters of hours” makes it more real than when I was half a world away.

As I read, even though I know it happened, I can’t quite believe that so much death and destruction in places like Rwanda, Burundi, Uganda, Sudan…occurred during my own lifetime. Shouldn’t such devastation register in my mind, even if I was only a child? Shouldn’t I have a memory of a newspaper headline, a TV news report, or a voice on the radio that spoke of the existence of the decimation of so many lives? I was alive, but I don’t remember, because these things never even entered into the consciousness of my life or the world, as it mattered to me.

The author of this book talks about actually physically being in Rwanda:

 

“I had never been among the dead before. What to do? Look? Yes. I wanted to see them, I suppose; I had come to see them – the dead had been left unburied at Nyarubuye for memorial purposes – and there they were, so intimately exposed. I didn’t need to see them. I already knew, and believed, what had happened in Rwanda. Yet looking at the buildings and the bodies and hearing the silence of the place, with the grand Italianate basilica standing there deserted, and beds of exquisite, decadent, death-fertilized flowers blooming over the corpses, it was still strangely unimaginable. I mean one still had to imagine it.”

(“We wish to inform you that tomorrow we will be killed with our families: Stories from Rwanda” (1998) by Philip Gourevitch (p16,pp1))

 

Even though the evidence stared him in the face, even though he could see it, touch it, smell it, the reality of it was not something his mind could actually grasp – He had to imagine it.

We express this sort of dilemma in everyday life:

“It’s too good to be true.”

“I can’t believe it.”

Why do we say these things? When reality threatens to shatter what we have previously known, believe to be true, or want to be true. 

I wonder how much it is possible to really relate to someone, to really understand them without having lived a day in their shoes. My American self reads statistics about poverty, AIDS, and war and sees pictures of bright-eyed children living in filth and my mind immediately jumps to the solution without really stopping to examine the individual fibers that make up a complex problem. What does it feel like to go hungry most days? What does it sound like to fall asleep next to your 5 siblings and 3 cousins in your house in the slums? What do you dream about for your future?  If the aim is to affect lives for the better in the future, mustn’t we understand what it means to live as things are now?

I find this frustrating. I can live in Uganda. I can see poverty on a daily basis. I can touch those who are suffering. I can smell the work of hard labor with little profit. I can eat the same food, walk the same roads, breathe the same air, but at the end of the day I will still be, somehow, separate.  No amount of time, language fluency, or relationship will change the fact that I cannot wake up one day and be Ugandan and know how that feels.  Imagination will only take me so far.

I know of only one case in which one was able to dissolve all distinctions so as to perfectly relate, perfectly understand, and perfectly love those who were impoverished, sick, suffering, dirty, captive, and disenfranchised.

It happened when God became man and lived with us.

I’ve been puzzling over this. God created man and man ensued to get himself into a hopeless situation. Sin…war, sickness, death, disease…

 “Then God said, ‘Let us make man in our image, in our likeness…” (Genesis 1:26a)

It’s bewildering enough to think that God would still love us, but why choose to intervene in the way he did? I mean, if we are talking about all-mighty God, why not just say a few words to fix the whole problem? But that’s not what happened. Instead God chose to enter into the fray. The unfathomable continues. God didn’t choose to say the magic words and fix the problem of sin; instead, He sent his son to earth.

“The Word became flesh and made his dwelling among us.” (John 1:14a)

The crazy part is that when Jesus came he didn’t just wave a magic wand around to fix the problem. Here is what we cannot quite understand – 

Jesus didn’t just COME, he BECAME.

 “(Jesus) Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death – even death on a cross!” (Philippians 2:6-8)

He was God, He was qualified to fix the problem of sin, but he chose to become 100% human, like us, so that he could know what it means to live in a dirty, broken, hurting, and sinful world.

 “For we do not have a high priest who is unable to sympathize with our weaknesses, but we have one who has been tempted in every way, just as we are – yet was without sin.” (Hebrews 4: 15)

God (as God) could have chosen to fix the problem of sin from afar. Instead he chose to KNOW us, to the detail of breathing, eating, walking, crying, loving, DYING…

“But God demonstrated his own love for us in this: While we were still sinners, Christ died for us.” (Romans 5:8)

So, the only message I can give to those around me, whether they earn $1/day or $1000/day is this: “I will put myself on the line to understand you, to walk in your shoes, to know your story. But I may fail and almost give up because it feels like a hopeless cause of being “too different” or “too hard.” So I want to introduce you the ONE who walked with me when I was dirty, destitute, and hopeless. His name is Jesus and he already KNOWS you because he made you. He already KNOWS your every fear and pain because he suffered them for you.”

This has been long. I hope you will read through these lyrics to a song called “We Come to You,” by Derek Webb, as my parting thought.

 

As you came to us, so we come to you

Fragile as a baby hopeful and new             

But learning fast that to walk is to fall

Soon we’ve done it all

 

We come broken and we come undone

We come trying hard to love everyone

But we come up short in all that we do

Because we do

So we come to you

 

As you came to us, so we come to you

Dirty and hurting then dead in the tomb

But raised redeemed to show off the scars

‘cause you’ve brought us this far

 

You came to show the way not around but through

So through it all we come to you

 

 

 

 

 

 

 

 

 

 

Saturday Club at Hope Alive! Kampala

Porridge for breakfast

Team building games with the secondary students...

Can they all cross the rope at exactly the same time?

Little wanderers....

Reading time with the visiting sponsors

Lunch time...

These two guys thought they were sooooo funny pretending to be pregnant...I thought so too :)

Feeding mind and body...at the same time

threads

My sister makes beautiful cross-stitch art; tiny and neatly placed “x’s” coming together to complete a unified picture or pattern. Colors are chosen specifically for the piece, each adding a new dimension to the final product. If you’re not an embroidery aficionado, however, you may not know that the backside of a finished project is nothing particularly nice to look at. In fact, it can actually look quite messy – unorganized knots and lines are not in any sort of pattern. The same threads with the same colors are still there, but they just don’t make any sense when viewed from the backside.

Today marks one month that I’ve been living in Uganda and I’ve been exposed to many of the “colors” here…. Ideas about money, family, health, relationships, music, transportation, dress, education, occupation, GOD…all blend together to make up this unique UGANDAN culture.

 When these things are viewed in the context of Uganda’s history and current situation, the picture takes on new dimensions. I recently heard a Ugandan leader share some statistics about this country:

·       Uganda is home to about 65 DIFFERENT TRIBES, each with its own language and dialect

·       Uganda’s population is approximately 32 million people

·       Of these people, 51% are CHILDREN under the age of 14

·       19% of Ugandans are MALNOURISHED

·       38% still live on less than $1/DAY

·       80% are subsistence farmers striving to live in a cash economy…leading to persistent famines in a rich land

·       In 2007, Uganda was home to 235,800 REFUGEES from Sudan, DRC, Rwanda, Somalia, and Burundi

·       While education is seen as an escape from the cycle of poverty, most families cannot afford to send more than 1 child to school for an elementary level education

·       When looking at the people of Uganda, there is visible gap between those who HAVE and those who DON’T

As if these statistics along were not enough to burden my heart, the speaker then made this comment to the “bazungus” (white people):

“YOU REPRESENT THE AMERICAN DOLLAR.”

Great. Now I feel like I’m swimming in my own guilt, the guilt of being born as a “HAVE” of this world. Not only do I live “in but not of” those who “don’t have,” but they see me as the visage of the dollar sign. Do I have a life response for what this means? A visible reaction or response I should make? Should I feel proud or ashamed? Besides feeling overwhelmed, I haven’t come up with an answer.

I am (as one person put it), like “a firefighter standing in front of a raging forest fire with only a cup of water.”

I look around me and see the hungry, the needy, the sick, the disenfranchised.  On the other end of the spectrum, I see people (both nationals and expatriates) who have committed their ALL to helping to alleviate the pain of Ugandans – people I could only aspire to be like. I feel, all at once, both lavishly rich in heritage and position and grossly poor in my qualifications.

It’s quite possible that moving to Uganda only brought a magnifying lens to what was already present in my life, even as I lived in America – if we open our eyes and really SEE what is around us, we will always find those who need in a way we feel unqualified to help. I’m going to include you, my reader, in this “we” as I say this – We excuse ourselves from responsibility far too often because we believe we could never affect change in such a hopelessly large predicament.

I heard this story once:

"Many starfish washed up on shore.  A young boy started picking them up and throwing them back into the ocean.  Someone saw what he was doing and told him that it was pointless, that there were too many to save, that it wouldn't make a difference.  Throwing another starfish into the sea, the little boy responded, "It makes a difference to this one."

 While I like this little tale of inspiration, I still not sure it moves me to action because it is still “I” who must provide the power and motivation to make even a small something happen.

So, one more quote, if I may, WorldVenture’s Africa director in response to this very predicament:

“we didn’t choose our origins or where we would be born – GOD chose these things for His benefit.”

A sigh in relief. As it turns out, I don’t have to feel guilty for being born who I am – a white American from a middle class family with a college education and a well-paying, respected profession. I do not have to feel guilty, but I must feel and act responsibly with what I’ve been given.

I do not have to feel pressured or under-qualified because I am not the whole picture – I am merely one thread, one color in the whole masterpiece God is weaving in the story of history – past, present, and future. My view of the state of people and this world looks pretty messy from where I stand, but that is because I am not able to see it from the Creator’s perspective…not yet, anyway.

 

 

“we should no longer be children, tossed to and fro and carried about with every wind of doctrine, by the trickery of men, in the cunning craftiness of deceitful plotting, 15 but, speaking the truth in love, may grow up in all things into Him who is the head—Christ— 16 from whom the whole body, joined and knit together by what every joint supplies, according to the effective working by which every part does its share, causes growth of the body for the edifying of itself in love. Ephesians 4:14-16 

“For now we see in a mirror dimly, but then face to face.” 1 Corinthians 13:11a