Ready to Talk

August 18, 2018

The other gods were strong, but Thou was weak.

They rode, but Thou did stumble to a throne.

But to our wounds only God’s wounds can speak.

And not a god has wounds but Thou alone. 

(Edward Shillito, from ‘Jesus of the Scars’)




This world is broken.  It is beautiful but so broken.  And I do not debate that the brokenness is everywhere and the suffering is without borders.  




A friend here once said that the dichotomy of our lives can be summed up as, “Cappicinno mornings and compound afternoons.”  There is wealth in Zambia.  There are hospitals, medicines, Land Rovers, mansions, shopping malls, and a subculture that plays polo on grand expanses of manicured, landscaped lawns.  Wealth is not evil.  It is the commodity of this world.  Even as I complain to my husband that I am “tired of being poor all the time!” I realize the irony of my words with my running water, electricity, a vehicle, and general good health.  But I have talked many times about how there is poverty here that is amongst the worst in the world.  Because it breaks my heart, knowing that children in Zambia are amongst the most hungry in the world is untenable and insomnia-inducing.


Zambia has “free” medical care.  In theory.  But “free" means long waits, lack of professional help, empty pharmacies, and perfunctory care at best.  Treatment is available for HIV in the form of USAID-funded ARTs.  However, shortages are common, secondary and opportunistic illnesses are not treated, necessary regular labs are not performed, and basic sanitation is unobserved.  The necessary nutrition for the ARTs to be effective is neglected.  There are good doctors, good nurses, and compassionate staff.  Those same people are over-worked and underpaid (or never paid; we know a clinic that has not paid employees for 9 months despite having regular funding from the US).  Even within private hospitals, the care has frustrated and baffled me.  Millions of dollars of direct aid has been poured into hospitals, clinics, and training in Zambia, but the results are not effecting change.  For all the horror stories, I can tell you stories of compassion, healing, hope, and love.  Those are not the stories for today.


I spent hours in the past sourcing medication for a little boy with cerebral palsy.  We’ve worked with him and his mother, and we relocated them so he can attend a wonderful program here in Zambia for children with developmental disabilities.  His mother has chosen to leave the program and return to live in a hostile environment with her family who told us they pray for the child to die.  At 2, he has very little head or trunk control, can’t eat solid foods, has daily seizures, and is constantly ill.  He had a fever last week, and his mother took him to the “best” public children’s hospital.  They released him the next day with a fever,  active pneumonia and a prescription for medication to control his seizures along with an anti-fungal.  ‘Livid’ is not a strong enough word to describe how I felt.  This mother was made to feel shame and guilt for her child’s health, although she has managed to keep him alive while barely 18 herself and without any support from anyone in the community or her family.  There are no schools, no seizure management, no inpatient care, no therapies.  Nothing she could access without our help and direct intervention (again, leveraging my skin color and wealth for others).  Even the medications prescribed are not available in the correct dosages or liquid.  I spent hours cutting pills, emptying capsules, and drawing up simple instructions for the mother to follow.  We are adding in food, juices, and vitamins to try to help her get the medicine in to her son.  But we realize that there is no good solution.  There is no way for her to work and for her son to receive the full-time care he needs.  There is no way for her to complete her education.


Our feeding program regularly has children drop in from the community around the church.  This past week, a little boy came in.  He wouldn’t speak to anyone, although he was happy to participate as much as he could and sit as close as he could manage to me.  As I am not a physician or specialist, I do not know the extent of his needs, but there were many.  He had visible facial deformities, trouble walking, some intellectual delays, and a nasty cold.  For him, the future is bleak.  The availability of care is so limited.  There is a great orthopedic charity hospital in Lusaka, but even transporting a child there and having the required full-time caregiver present is more than most families can manage even if they are interested in helping their child.


And then there was Naomi.  At four, she was smaller than a toddler.  Her persistent hunger was obvious in more that just the jutting bones.  Her grandmother was well-fed and seemed to care for her, but the medical non-compliance had gone on too long.  She was admitted to the malnutrition ward for intensive nutritional therapy for the fourth time in her short life.  As I visited her at least daily, we got to know more about her family and the care available to her.  We spoke with the amazing attending pediatrician who advised us to find hospice care for her as her situation was terminal.  He was frustrated by the care he was legally obligated to give her, knowing that nutrition therapy and lack of pain management were only prolonging her suffering.  We did what we could, bringing her blankets and clothing more comfortable than those provided, food for her grandmother so someone would stay with her, and making sure her daily feeds and vital signs were actually noted and fulfilled.  We found a wonderful Catholic hospice center and secured a bed while we waited for the hospital to complete the necessary paperwork.  By the time it was completed, she was not conscious, and the hospital would not release her.  The next day, I walked in while a nurse was completing a feed through a NG tube, and I watched as she roughly pulled it out and walked away without any thought for the child on the bed.  


I am afraid I spoke rather harshly and moved quickly to the bedside.  Her bedding was completely soiled, but I had a new, soft blanket with me.  Cleaning her up and wrapping her in it, I felt her bones beneath tissue-thin skin, the heat of her fever burning through the blanket.  She made only one pitiful whimper.  Helpless, I prayed.  Through the fear of watching death lower over her, through the hope of healing, through my own lack of faith and blinding anger, I prayed.  Words ran out even as tears dripped off my face.  I never saw her alive again.  When I entered the ward the next morning, she was dead.


Injustice, death, and pain are a reality.  And while I strive to portray people with the dignity they deserve, the fact is that sometimes this broken world has tried to strip away any dignity that remains.


What does remain?


In the face of these challenges, it seems trite to say, “love.”  But these things have torn off every other answer I might have had.  Surrender meets us at every turn of life, asking more, and wanting more.  And if that was all I believed, cynicism and doubt would overtake me.  


So I hold to the inexplicable mystery.  To something that I cannot understand.  To the One who asks me to trust.  To hold to Him with my hands and heart bleeding with sorrow.  To the One who holds me with hands and heart pierced.  Who weeps with me.  Who sorrows more than I.  The One who came to be God with us, entering into our humanity, constraining Himself to be with us in flesh.  Who asks me to follow Him.  To do justice.  To love mercy.  And to walk humbly.



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