I've been really cut off lately. I got a new smart phone while in the US and it should have been rather straight forward to get it connected to a Ugandan network. But nothing in this country is straight forward. I needed to do a sim swap and went daily to the network shop and initially they didn't have 4G cards to sell. Then the cards arrived and the staff person who knows how to swap wasn't working and they weren't sure when she would be back. Then finally (after several days off) she showed up for work and she said their internet network wasn't fast enough to do it. Which, I should have seen that coming because for the first two weeks here I've had no internet to speak of. I mean, I paid 300,000/= (about $125) for data on my modem and it connected but it was too slow to even connect to e-mail. But, seems like I didn't actually want to be following the news this week anyway.

On being anonymous

I have not been here long enough to miss pizza yet or even have gotten over my jet lag. But I already really miss some things from Michigan.  

Turns out the very first thing I miss from being in the States is being anonymous. I’ve gone for three runs since I’ve been back and I’ve already lost count of the inappropriate comments, the kids yelling at me or the people pointing and laughing.

A few weeks ago, when I was training for the tri, I had decided to go to the beach to do an open water swim workout (in Michigan). On the way there I couldn’t help but think, people don’t go to the beach alone, and they really don’t swim laps back and forth beyond the swim bouys, and people are going to stare at me. But, turns out, it didn’t matter. No one even looked at me twice. (Or if they did it was subtle enough that I didn’t even notice.) And I loved it!

Yesterday while in market several people welcomed me back. Which seems like it should be nice. But the conversations went something like this:  “You’ve been missing!” “Yeah, I went to go visit family.” “Next time, you take me with you!” or “I always want to go to America! Get me a ticket!” I kid you not, roughly some variation of this conversation happened three times. This seems to be a bit of a running joke with Ugandans. But it is not completely a joke. They say it to most foreigners and they mean it. They really want to go to America. But the truth is, very few of them will ever get the chance. So what is my response supposed to be?  Do I just smile and laugh?  However, I’m very sensitive right now to how unequal things are. I don’t find it funny that they will never be able to travel to neighboring Kenya, let alone America. And the truth is, they are actually sensitive to it too. They joke about it but only because it is something most of them really, really want. So, I really don’t like having this conversation. Especially with people whose names I don’t even know and who don’t know my name. Why is it OK that the guy I purchase meat from once a month demand I get him an airline ticket to the US?!! Yet, I can guarantee it will happen many more times this coming week. I would rather walk through market and not have anyone recognize me.

Here is another one. Still in the market, I was having a lady measure out 5 kg of rice for me (which takes a surprisingly long time considering she does it 200 times a day) when the lady in the neighboring stall picked up her toddler and pointed at me and said “See muzungu!?”  This is also very common.  Like if you saw a deer while driving you’d say to you kids “See the deer!?”  But they do it with white people. And they tell their kids that we will eat them if they are naughty.  I am not the bugy man! And I don’t think it is funny when you scare your kids with me.

Anyway, back to the lady measuring rice. While my hands were full with my other market items, and I was trying to make change to pay for my rice, and juggle the 5kg bag she was handing me, her young children, probably six and four came up to me and tried to greet me. They were actually pretty cute but I declined to shake their hands. So as I walked away I heard the two ladies talking about how terribly rude I was. And maybe I am. But I was going to have to set something down on the floor in the market to shake their hands.  And they were filthy. Their hands were covered in grime from playing in the mud. And the truth is those ladies would not have expected any Ugandan to shake their child’s hand in that situation. But all day long I’m expected to greet the children who are screaming greetings at me. Maybe I’m just being overly sensitive about this. But when a group of children in my neighborhood are playing (and they are always in a group!) One will see me and start yelling “Muzungu, Muzungu! How are you?!”  And if I ignore them they eventually go back to whatever they are doing (though not without yelling several more times in case I’m just deaf.)  My neighbors think this is terribly rude. I guess it is. But if I actually respond to them, every single one now has to ask “How are you.” I am not exaggerating. I will have to hear “how are you?” and say “fine” for every child there.  No Ugandan has to do this. Children would never scream at them as they walk or ride by.

And don’t even get me started on the inappropriate comments from young men. Let’s just say that “Hey baby, you’re just my size” is the thing said to me yesterday that bothered me the least. 

Ok, this rant has gone on far long enough.  

Back in Uganda

Travel this time was mercifully uneventful. It was three plane rides totaling more than 22 hours, two layovers of two hours each then eight more hours of drive time. But no luggage was lost, no connections were missed and I wasn’t harassed by any TSA agents. Overall, a success. Benj and Christina met me at the airport and delivered me to Soroti.   

I'd have pictures for you but the internet is just too slow. You'll have to just believe me. 

Triathlons

Back in January I felt like I really needed to start training for something and a triathlon seemed achievable.  Then reality set in and most of the time it felt like I’d never be ready.  But June in Michigan proved fortifying. I got some solid swims in and the change from my antiquated and poorly maintained Ugandan bike to my racing bike made it seem possible again.

Transition 1

This swim was terrifying!

So, I managed to complete my first Olympic distance Tri and do far better than I thought I would. The mile swim was cold and long but I completed in 33 min, then a 40K bike ride (25 miles) in just over an hour then a 10k run in 52 minutes. I was the 5^th female to finish and the 14^th overall out of a field of about 150. Final time: 2 hours, 45 minutes.

I'll walk again eventually. 

The following weekend went up to Big Rapids and after an eleven year hiatus, I reclaimed my title of fastest female in the CHR sprint triathlon. All the distances felt way to short and painfully fast after the long one but it was a fun day and didn't require nearly as much recovery time. 7:30 for a 400m swim, 20 min for a 5 mile bike and 25 min for a 5k and barely two min in transition I had a final time of 55:11.  (1st Female, 6th Overall out of a field of about 75).

Look! Only four seconds behind Michael Phelps!

Transition 1

2006 and 2017

Lots of family and friends came along to cheer and we had a nice picnic lunch (and a recovery nap!) on the beach after.

6/24

On this blog I've always wanted to be honest about  my flaws and humanness. Just because I'm a missionary does not mean I've even remotely got things figured out. As soon as I start thinking about outward appearances I see it first here, on social media. "What can I post or write or show pictures of that make me look good (or at least like I'm not falling apart)"?  So here is me trying to be honest again. I need to admit that I'm a bit unmoored right now. Webster says this means "to loose from anchorage." But the second definition is "to bring to the state of riding with a single anchor after being moored by two or more" and I like that one better.

I know in my head that I can't keep functioning the way I was in Soroti. After this break I could go back to it and survive and maybe even do some good for people for a bit again but I'll be right back to this place. The suffering and needs are just too much. I don't know how to give what I can and not be overwhelmed by the magnitude of the remaining needs. So, something needs to change. I don't know what that is. Do I need to find a medical team to join? Possibly in Karuma, or Jinja or Mbale? Do I need to do something radically different in Soroti?  Am I still being called to work in Karamoja?  Am I supposed to be done in Uganda for now?  I don't have the answers to any of these questions and God has been very quiet when I ask (over and over again.)

So for now I'm resting and praying and trying to take small steps. I'm trying to deal with false guilt and real anger.  And for the first time in awhile I experienced God's presence in a reassuring way. I'd been missing it for a frustratingly long time. God reminded me in my quite time today how important my daily bible reading was. I was still readying and studying it but merely as a hoop to jump through early in the morning. Thanks so much to all of you who have been praying for me because "you have not because you ask not" applies to our scripture reading as well.  I had not been asking or expecting anything from the scripture I was reading for quite a while now.

Setting your mind on things of God leads to enduring delight, genuine joy. I'd been missing this for too long. The suffering and daily grind seemed to be all I could see. There was no joy in it. But, He is restoring His joy. Mostly it is in swimming and my nieces and lots of manual labor but I'll take what I can get.

Newsletter

I sent an update/newsletter out early May but I'm realizing how few people got it. For those of you who didn't, sorry and here is the bulk of it.....

It is always an adventure here in Soroti. My watchman just came to the door to tell me he saw a cobra in the garden and he suggests I keep the kitchen door closed. So besides snake hunting, I’m keeping very busy with regular clinic work three days a week, lots of home visits and occasional teaching in a variety of venues.

Because my work permit is now being issued through the church in Obule I’m in the village almost every day of the week and the needs are overwhelming. It seems like there is almost always a woman laboring in the clinic or someone who needs to get to the hospital or malnourished kids who need follow-up. I love working with my tiny village church that really has the heart of God and serves sacrificially. The daily grind, however, has really worn me down. The needs are endless. I’ll be honest, I’m struggling right now. So I’m taking some time off. I’ll be back in MI for six weeks to rest, pray, spend time with family, take a break from this place and get my head on straight. June 21st to Aug 7th. It is a short time and isn’t a furlough so I won’t be doing the regular home assignment activities.

Prayer Requests:

• Wisdom and discernment. I’m inquiring of God if He has ministry changes in store for me. Please pray with me that He would show me His will and I would have the strength to be obedient to it whether it is to change or keep doing what I’m doing. 
• I’ll be attending a spiritual retreat for cross- cultural medical providers and also meeting with a counselor to deal with some burnout when I’m in MI. 
• Rest in God’s presence and trust in His goodness.  Peace, contentment and joy in Him alone.

Travel

If you ever have the opportunity to travel internationally with me, may I make a suggestion?  DON'T. I do not have a good track record lately. I'm pretty sure I've missed more connections in international airports than any other person I know. This last trip was no exception. I left Soroti at 6am and got to the airport in plenty of time, around 4pm, with a scheduled departure of 6:30pm. By 7pm the plane was still not to the airport. We learned later that Saudi airspace was closed and so the incoming Qatar plane had to add two hours of flight time in order to go around. Then turn around for the plane in Entebee took at least an hour because Ugandan's just can't move quickly so our departure was more than three hours late. Then the five hour flight took seven so I arrived in Qatar more than two hours after my flight into the US left. So I was re-booked (along  with the majority of the plane so it took awhile) at 4am for a new flight that didn't leave for seven more hours. We were all given meal vouchers and reminded that it was Ramadan so food couldn't be purchased or consumed after sunrise. I was so tired I found a tolerable chair and fell asleep for awhile, was woken by a cleaning crew at 5:30am only to discover I missed sunrise.  I tried to tell myself I would be fine but after doing the math and realizing that it would be more than 12 hours since the last time I'd eaten if I waited for the next in-flight meal and I was already too tired and irritable I'd be dangerous if I added really hungry to the mix, I pretended to be pregnant so I could buy a juice. This lie doesn't bother me at all.  Another challenge in Doha was that I somehow needed to get word to my family that I would not be coming into GR on the flight they thought I was. But my little Ugandan phone was useless and due to the airline electronics ban (for all flights into the US from middle Eastern countries), I had checked anything else I could have used. The airport does have a place where you can use computers so I got a message out but I suspect it was a bit cryptic.....

Anyway, I did finally arrive in Chicago though that continues to be the worst airport in terms of courtesy and reasonableness. You are treated like a criminal in customs and immigration, even if you are an american citizen. I can't imagine what it is like for foreigners. I want to make a shirt that I'll call my travel shirt. It will say something to the effect "I have not slept prone for more than 36 hours, I'm eight time zones ahead of you,  I've eaten nothing but airline food and I've tried to use several currencies. I want to be compliant but I need you to speak more slowly, enunciate a bit and stop yelling at me." I know it is too much for a shirt but a girl can dream right?   Three or four weeks ago, in Soroti, my watch broke and I kept trying to duct tape it but when it got wet the tape would slip. So I used a heavy gauge retention suture and stitched it on. I didn't even think of it in the airport and had made it through at least six security points before Chicago but it was there they pulled me out because I had to take my watch off. I tried to explain that it was sutured on. They said it didn't matter, it had to come off. I said, I'm willing to take it off, just not physically able. If they wanted to give me something sharp to cut it I would. They explained it was a security point, no sharp things allowed. I kid you not, it took me more than an hour to clear this check point.
Anyway, 9pm Thursday night, almost exactly 48 hours after I began traveling from Soroti, I arrived in Grand Rapids. I think my mom fed me and I'm pretty sure I found a bed but it is all a bit hazy.

So, cat is out of the bag.  A few of you saw me at church on Sunday. I'm back in MI a few weeks early. I came back because.... you know, if you say "I'm not sure I can do this anymore" out loud enough times, it becomes true.
Friday AM found me headed to the hospital to do some teaching about HIV and I got a frantic call from the grandmother of baby Jennifer. (First blog here.) She told me Esther had dropped the baby and she was now "acting strange."  I met them on the way in from the village and it was obvious from the moment she handed her to me this was a dying baby. We rushed into the hospital and I commandeered a treatment room for a set of vitals. Later, upon further questioning it seems Esther actually shook the baby because she wouldn't eat. She was extremely dehydrated when I first got her so I'm not sure if there was something more going on before the trauma or not. We rushed into the NICU where we did all we could with our limited resources but at noon I unhooked her from everything and handed her back to her grandmother to take her final breaths. Then grandmother needed help transporting the body back to the village so I took them home. Esther didn't know yet the baby had died and it was terrible to see. This mentally handicapped mother knew she was the cause of her baby's death. She started screaming and throwing herself on the ground. Most of what she was yelling was in Ateso but she would switch into English and tell the baby over and over that she was sorry, so sorry. The culture uses wailing to notify all of the neighbors of a death and everyone comes over to see and mourn together and this was no different. Grandma and Esther started the wailing and each new woman who arrived added to the weeping and keening. This baby's death just seemed so needless. We had done so much to give her a good shot at life. I loved this little peanut.
Between her and a few other cases I just needed a break.  The suffering and need is never ending. I tried to take Saturday off and my phone rang all afternoon and there were several people knocking at my gate. It is just as hard to say No and send them away as it is to engage in their need. On Sunday at church a woman brought me her two extremely malnourished children and with tears in her eyes begged for help. I just wanted to go to church and not be responsible for a few hours. But it seems there is no way to be off duty. I feel wrung out and like I've got nothing left to give. I can't seem to find contentment and I know I'm working in my own strength instead of God's. So it is time for a break.  Some prayer and perspective.

Another little one to pray for

Jarod is one year old and is suffering the effects of someone dumping concentrated quinine into a sub-q scalp IV. Poor little guy has been in for surgical debridement twice and still has a long road ahead of him. 

Holding him down as anesthesia wears off before they are finished.

He is at very high risk for sepsis, meningitis, or any of a whole host of other unpleasant diagnosises on top of the fact that it is really painful and he is terrified. He is extremely malnourished (as is his mother and five year old sister who is the size of a three year old. His cheeks look nice and fat but that is edema from Kwashiorkor.) His father is an alcoholic and I've been out to their home three times and never met him.
We have him admitted at Bethesda because he needs twice daily dressings under sedation and IV abx but I really had to push for his admission. (He was discharged after the first surgical debridement but was feverish and lethargic yesterday and I just can't give him the care he needs at home.) I'm having a terrible time trusting him to the staff there and I just really want this little guy to have a good outcome. Please pray for them and me.
6/6  Update for all of you praying: He is doing really well and loves eating atap and meat at the hospital. He is still inpatient there but all signs look good. Praise God!

Esther's little baby

Esther's little baby died early this afternoon at 18 days old in Bethesda's NICU. She weighted 1900 grams. I wrote about them last here. Please be praying for Esther and her mother. 

Swimming

Even as I look at these I can't believe how much Soroti has changed in the 7 years I've been here. But we have a really nice pool now. Specifically for kids. The students I sponsor have been begging again and they know this is one of the few things I'll cave on because I love to swim too. 

Well, I agreed to take them. Unfortunately there were literally a hundred kid there. Most who clearly had no idea how to swim. Terrifying!

Anyway, here are my eight. 

They all head back to boarding school on Monday. 

Following up

Lots of follow ups today.....

On the 8th I was in the midst of a complicated labor when a lady with a snake bite came into the clinic. She had been picking up firewood and a cobra got her on the hand. I went to see how she was doing today and here is what I found. I know it looks a bit gruesome but I'm actually ecstatic how great it looks.  I was pretty sure there was a good chance she was going to lose the finger at least and for a while I was worried about her life. But this is just routine dressings for a long time and eventually she will be back to normal! 

Then little Mary who had tetanus back in December. She is now a healthy kid. She is still the only tetanus case I have had survive. She WOULD NOT smile for me, which is really sad because she smiled all the time in the hospital (once her muscles relaxed enough that it was physically possible) but I suspect she has a really hard life. She is HIV positive and lives with her elderly grandmother who needs her to work too much to send her to school.

Lastly I stopped by the home of Esther and her baby who is two weeks old today. They are all doing fine and the grandmother reminded me that I was the one that first diagnosed her HIV. I did not remember that but I guess it was significant enough that I blogged about it. TBT...2012 and the next day.

Family

When I want to be there so much it hurts....
My family grew this week and I'm on the wrong continent.  (By the way, I realized these are slightly confusing pictures, Nick and Katie had a baby, not Chip and Susan.)

Update on Jennifer and Esther

Update on Esther and baby Jennifer. I first wrote about them on Sunday. 

They were discharged today (still on some valium) so I brought them back home. 

 This is Esther with her first born, Emma. He is four years old.

Grandma holding baby Jennifer surrounded by neighbor kids. 

This little peanut went home today weighing 2.25kg.

I had no idea when I took this job how much time I'd spend teaching. And the strange topics. Today, I taught at a parenting conference. I'm perfectly well qualified for that. 

I'm just kidding. I did teach at a parenting conference but about keeping children healthy. I'm at least mildly qualified for that, I guess.

 Fever, diarrhea, and antibiotic resistance, my favorite topics.

For my nursing friends, at least you weren't getting transfer report from me this morning. Me: "I'm bringing you this patient from Obule Health Center. She is a G2P0 in active labor.She was c-sectioned last pregnancy. I don't know when her labor started as she won't talk. Her water broke about 25 minutes ago. I don't know how dilated she is as she won't let me check. I don't know FHTs as she won't let me near her. She is mad (meaning mentally ill) and HIV positive. This pregnancy is the result of insestual rape." Nurse midwife receiving report: ".............." Me: "Which doctor is on today?" Her: "No doctors currently on duty." Me: ".............."

So, update:  Lets start with the good news. Mother did finally get her c-section.  Both mother and baby survived the experience.  Ummmm, I think that is about where the good news ends. Keep praying.  Mother responded very poorly to anesthesia (general, not spinal). First under anesthetized, then way over. Now, out of her mind. Kicking, hitting, biting. She has pulled out two IVs and her foley. The baby was next to her on the bed for a few minutes and she almost successfully threw it on the floor. Baby is doing slightly better than her mother but also needed serious resuscitation (possibly for the same reason her mother did?!) Tiny little girl. Weighs four pounds. She can't seem to keep her body temp up and power is off so they aren't putting her in an incubator but at least now her sats are holding. We have not successfully gotten Retrovir  (infant antiretroviral prophylaxis) because it is the weekend, but hopefully tomorrow. 

This is baby girl with her grandmother. 

Mother after we had to knock her back out to keep her from hurting herself and us. 

My sediments exactly, kid!