Friday, March 20, 2009

God Save the Queen




This past weekend was my first trip to Queen Elizabeth National Park, a huge park on the other side of the mountains, about a 6 hour drive away. We spent the weekend there to say goodbye to the Chedester family, who have been working with World Harvest in Fort Portal for the last 12 years, and are leaving Uganda in May. It was nice to get to spend some down time with them, and Queen Elizabeth is a spectacularly beautiful place. We stayed in a lodge built right on the edge of the escarpment overlooking the park - the little porch of my banda was just on the edge of a 200 foot drop to the plain below. Add to this the fact that it's actually quite affordable, and the Kingfisher Lodge becomes a perfect getaway (and 6 hours is about as close as anything else).

Saturday was an amazing day, partly because I got to watch Liverpool thrash Manchester United 4-1, and partly because I had a rare day of relaxation (in a truly beautiful place, none the less). On the way in, we kept our eyes out for satellite dishes in the villages near the park, and at game time I drove from the lodge with the Myhres and the girls to a building with walls of rough hewn boards and cardboard, a dirt floor, a corrugated steel roof, wobbly benches of split logs, a satellite dish on the roof, and a generator puffing away outside. I almost had a heart attack numerous times, but Liverpool pulled away in the second half and I celebrated with a bunch of Ugandan men. Serious fun.

Sunday morning we went for a game drive, starting before sunrise, with 11 of us in and on (mostly on) the Myhre's Land Rover. Despite my eyes becoming better trained at spotting a variety of animals, we saw little other than kob, cape buffalo, and waterbuck for most of the morning (all beautiful in their own right, but none of them rare or unusual). Soon, however, the other team called us to tell us they had spotted lions, and we soon found them and the lions. We then headed to a favorite place in the park (where I hope to do some camping sometime), and while driving through the brush, we stumbled practically right into the middle of a herd of elephants. It was amazing and powerful, and a little scary, being in the back of a truck. On our way out, we skidded to a halt as, Ashley had spotted something to the side of the road. For a few moments, I had the rare privlige of seeing a reclusive leopard, only about 50 feet away, sublimely beautiful and shimmering as it moved through the grass, slowly melting into the brush. To give you an idea of how rare this sighting was, that was the 4th leopard that the Myhres have seen in their 15 years living in Uganda. That I saw one after less than five months makes me unbelievably lucky.

The weekend was short, and the ride back was long and bumpy (with a stop for pictures as we crossed over the equator). By the time we got back to Bundibugyo, my hands were tingling from holding the steering wheel and my shoulders were tense from the stress of driving the Bundibugyo road. But it was a beautiful, meaningful, and relaxing weekend, where we had the chance to honor the Chedesters and wish them farewell. I might never again be lucky enough to see a leopard in the wild, and I consider myself blessed to have had the chance to see something that rare and beautiful once. Within 15 minutes of getting back, I was down at Christ School to train with the team, getting ready for our first game. And that's how the pace of life has been for me - from one thing to the next, some fun and some difficult, some relaxing and some stressful, some maddening and some refreshing, but never a dull moment.

Thursday, March 19, 2009

Season opener

Yesterday, the Christ School boys football team kicked off their season in... something less than style. While a 2-1 come from behind win is a positive result, the game was ugly and we played terribly. The interesting part is that, in training on Saturday, the boys looked good and were playing pretty nice football. Perhaps it was the pressure from the hundreds and hundreds of people lining the field, screaming and beating drums, that caused them to lose composure, but whatever it is I'm hoping to be able to fix it before the next match on Saturday.

The atmosphere was electric, with so many fans, and I've never seen so many people gathered in one place here in Bundibugyo. It was great to have an event that drew so much of the community together (even if they were often poorly behaved).

I spent much of the game slowly and quietly pacing the sideline, punctuated with frequent violent outbursts of screaming and gesticulation (partly out of frustration, and partly just to be heard above the roar of the crowd). My throat is killing me today. This must be retribution for all of the frustration and yelling directed at me by my various coaches over the years.

Even with the season only days old, there are already accusation of schools bringing in "mercenary" players - boys who aren't students but are good footballers, or who are too old, being issued IDs and playing in the tournament. From what I can tell, this happens every year but at least now it's beginning to be caught and punished. The team we played yesterday even had a man who I would place at about 45 years old! I started cracking jokes that Alex (the head coach whom I work with) and I should go get our jerseys too. But, by some loophole, because he passed his primary school exam in the last few years, he's still eligible to play. Don't ask me how that makes sense, but apparently it does to whoever wrote the rules.

So the season is off to a positive, but frustrating, start.

Thursday, March 12, 2009

Good Food





On Tuesday and Wednesday of this week we started up the latest cycle of the BBB nutrition program, an outpatient program designed to provide nutritional support to children with moderate acute malnutrition. I’ve just taken over managing the program (don’t ask me if I’m remotely qualified for this), so this was my first real experience with it beyond the planning stages. The program is based at two small health centers, about 10 minute drives in either direction, where we stage weekly food distributions. Previously, World Harvest had started community based production teams to produce the food we distribute, a g-nut paste similar to peanut butter and a type of soy flour, which we then buy from them and distribute to malnourished children. The idea is to use locally available foods, ones that mothers themselves can make, and to perhaps help create a market locally for the g-nut/soy food (if anyone other than us decides to buy it from the production teams).

 

In any event, this week was screening and enrollment, so I, along with Baguma, an extremely competent young Ugandan man who works on nutrition with us and has become a friend of mine, spent hours weighing kids and measuring their height and MUAC (mid upper arm circumference), which we use as enrollment criteria. Moderate acute malnutrition is defined as being between 70-85% weight for length – that is, children between 70-85% of the weight of a healthy, normally developing child of the same height. Of course, the children who are brought to this distribution are going to be smaller and thinner than average for the population, but it was depressing that, in two days, I saw only one child who was at 100% weight-for-length, and several below 70% (it’s hard to survive for long below that point). Screening the children and deciding who to enroll was both interesting and emotionally taxing work. In a room of 50 kids, all of whom are malnourished to one degree or another, it’s hard to decide who will get the food and who won’t, but lines have to be drawn somewhere, especially when working with limited resources (both financial and manpower). The cutoffs, while not arbitrary, have to be defined, so I was several times faced with kids who met none of the criteria but were clearly malnourished, while other kids qualified but looked pretty healthy. Those situations were difficult, as I felt torn between the need for some sort of system and the desire to help everyone who might need help. Of course, I must remember that my ability to help anyone here is dwarfed by the size of the need, but those hard judgment calls were both stressful and fascinating. I found myself really enjoying the clinical aspect – there I was, evaluating kids and making judgments based on a number of factors, including my own opinion of what sort of shape they were in (pretty scary since I’m not medically trained). That process was an exciting challenge, but was also very heavy, since wrong judgments on my part could have very serious consequences.

 

I was excited to be out in the community doing this screening work, especially when I discovered several kids who were in very bad shape (Kwashiorkor), who I instantly referred to Jennifer at the health center. It felt like very real, hands on work. Toward the end of each session, Baguma gave a demonstration of how to prepare this food we were distributing, followed by a taste test for all of the enrolled kids and their mothers (a few fathers even showed up!). There was something sublimely beautiful, peaceful, and just right about a room full of malnourished kids with their hands and faces covered in food. It felt like the world was a little more the way that it should be, a little more in order. Children who just need to eat, getting the chance to eat some good food – it made my day, both days.

 

It’s easy to romanticize this work and trumpet its importance, when in reality some of these kids won’t improve, some will likely die in the next year, and it can be hard to know what impact it’s really having.  Those are the difficult realities of work and life here. However, there is real joy in the simple act of lending any sort of helping hand to someone in need, and while I can strive to achieve certain outcomes, I only have so much control over them.

 

These enrollments were long days, ending around 7PM both times, and I found myself by turns stressed, excited, exhausted, frustrated, happy, brimming with anger, and laughing both days. But at the end of each day, tired and weary, I was able to look back and see good things happening – kids getting food, mothers learning about nutrition, and, I hope, families getting on a track to a healthier future.

Monday, March 2, 2009

A rant, updated

The day after I posted my angry indictment of the Ugandan health system, we got word that the shipment of ARVs, for which we had been waiting for months, had arrived at Bundibugyo hospital and that some of them would be brought down to Nyahuka for the ART clinic the next day. It was a huge relief to everyone, and I can only imagine how much more it means to the people who are benefitting from these drugs. Only one small problem remained – Wednesday, the day of the ART clinic and the promised delivery date for the drugs, we got a phone call that no one would be bringing them. “This person is busy…” “I’ve just been called to a meeting…” “He can’t come today…” The drugs had made it all the way from Kampala and were then sitting a scant eight miles from the health center, and no one felt it worth their while to do their job and transport them that last stretch. I was livid; I could have hit someone. It was simply infuriating that a medical system could be that broken. It’s fascinating to me that people being paid for this work can simply ignore it to that degree, especially when not doing it can directly cost people their lives. So, into the 4x4 I hopped and drove up to Bundibugyo town to pick up the drugs, a very simple task for which I’m no more qualified than anyone else, only that I was willing to do it.

That made me think. Was my quickness to jump in the truck and go collect them one of the reasons that no one would bring them? If there were absolutely no other way, would someone from the hospital have brought the drugs? I wonder if some of these behaviors prevail because some people know that, when it comes right down to it, the bazungu (white people) will do it anyway. There’s no doubt that everyone, including me, feels less responsibility for work that will get done without them. I wonder if my eagerness to help may in fact help perpetuate the brokenness of the system. I wonder where the line is between helping where help is needed, and permitting people to shrug off responsibility, allowing the system to remain broken. We have sometimes talked about the principle “First, do no harm” – creating dependency is definitely harmful in the long term, but how do I try to meet people’s needs in a way that doesn’t create some level of dependency? It’s hard to know. And then a part of me always says, “forget all that theory, just see if you can do something to improve someone’s life.” I think that it’s good to have that attitude as well, but then you can quickly come back to the problem that what’s good in the short term can create long term problems. So, stepping back, my reasoning has taken me nowhere. I’m still at a place where systems are broken and I can’t do anything about it. A place where I don’t really know how to balance meeting needs against creating dependency.

I suppose that, if this were easy, I’d have already read the answers in a book.

Sunday, March 1, 2009

Book Review: The Shack

I may, from time to time, post reviews of books that I've read. Here's one try.

The Shack, By William P. Young

This is a book that’s created quite a stir in both Christian and non-Christian circles, and in both positive and negative ways in each, so I felt that it would be worthwhile to read it and see what it had to say. For a New York Times bestseller, I was quite surprised at how overtly Christian this book is. The story of a grieving man’s struggle with and very literal encounter with God, this book begins an interesting discussion of God’s role in earthly events, his relationship to humans, his nature, and people’s general understanding of who God is, in a way that is distinctly post-modern rather than modern. The writing itself is rather pedestrian and sounds a bit stilted at times, but it is accessible while retaining an ability to communicate deep thoughts, even if it lacks a certain elegance. Probably the best thing about this book is that it presents a depiction of God that differs significantly from both religious and non-religious mainstream American understandings, which, to my mind, is a welcome perspective. While perhaps I haven’t thought in depth through all of the theological implications, I think that it provides an important challenge to traditional American cultural understandings of God. If I were a critic, I’d give it three out of five stars – interesting and worth reading, but not, in my mind, a stellar piece of literature.