telling hope stories

it is difficult when an organization or non-profit or mission group enters a place of extreme need, to know where to begin.  so triaging occurs, attempting to reach the most broken places. the problem is sometimes gaping wounds remain untouched while attempting to salvage the most devastating injuries.  when i got to bulembu, swaziland, the gaping wound looked like this:

children, too young for school (or old enough for school but unable to pay school fees), would stay home while their parent worked.  there was no day care; even if there was, it was unlikely any parent living on US$60 a month could afford it. and so once a child was too heavy to be carried on her mother's back during work, the child would be left home, under the care of older (meaning age 5-6) children.  a pot of room-temperature cornmeal mush would be left for lunch. 



it was painful to pass these children. to know the work i was doing with children orphaned by hiv was important and necessary, but to still pass these hungry, left-alone children with scabies under their skin who were fortunate enough to still have a parent.  my housemate and i could not keep doing nothing.  we knew the organization did not have the capacity at that time to establish any long-term solution. but we knew we couldn't keep walking past, doing nothing. so on saturday afternoons, we toted tins of grapefruit and a dysfunctional can opener into their neighborhood and would play with these kids:

we were a band-aid (if that). a desperate attempt to do something, to not close our eyes to what was happening around us.  we were limited.  we cried and we prayed and we hoped that someday things would be different for these kids.  an answer to those prayers came shortly after i left swaziland: a woman from the uk came to bulembu to set up a care center for those very children that had evoked my tears and worry and food and prayers for so many months:

it is called enduduzweni, which means "place of comfort."



my friend zandi works there now. the care center has grown over the past 5 years, and it now expanding to include baby care.  i am told that zandi does an amazing job, that she has a gift for working with children. i knew that though.

this story is incomplete. it is only a small part of the story, limited by distance, detached from the daily struggles of those who now carry these children.  i am not trying to romanticize what is chronically an uphill battle.  i cannot speak to the gaping wounds that still exist that break the hearts of those who are there now.  

i know that love poured out during the day doesn't negate neglect at night. that tummies filled at lunch time may not be filled again until the next morning. that moms who build loving families and still get hiv from dads who work in the big cities. that summer floods wash away roads and houses and crops and threaten a precarious economy.

but it is still a story of hope. of tummies now filled during lunch that would have otherwise been hungry.  of kids left alone on doorsteps while their moms work now with safe places to play and learn and be cared for. of people choosing to offer love despite struggle and suffering and cost. i know what was, and what is now. and it gives me hope.  
i know that the story of these children is not over. the story of edudzuweni is not over.  the story of swaziland is not over. and so again, still, we wait for hope to come true.

"for there is still a vision for the appointed time;
it speaks of the end, and does not lie.
if it seems to tarry, wait for it;

it will surely come, it will not delay." - habbakuk 2:3

(ps - if you want to give to enduduzweni, click here. it costs US$150 a day to run the center - which feeds 100 children, pays the salaries of 8 caregivers and cooks, and assists vulnerable children with medical care and school fees.)

one of those days

"i think part of the struggle just of everyday life is

remembering that the love is there...to wake up in
the morning and realize that love is there in the world -

if i can do that, that's half the battle." - kathleen norris

i was grumpy. and exhausted. and sick.  and i had an out. 

but i was also stubborn and trying to prove i wasn't that weak, and i said i would go see patients in clinic that afternoon anyway.  then take a sick day tomorrow. 

i regretted that decision as soon as i walked into the building.  it hit me how very tired i was. how i could be home napping instead. but it was too late now.  oh well.

the first chart i grabbed wasn't that heavy. i figured it would be an easy patient. until i realized that this was chart volume 2.  i scanned the face sheet: hiv. bone disease causing 2 hip fractures. cancer. depression. chronic pain. neuropathy. 

as i was heading down the hall, the nurse practitioner gave me a heads up: he just got a new electric wheelchair. and he cut his hair.

i walked in the room, expecting someone grumpy and bitter and sick.  instead, he was smiling. 

how are you, i asked. honestly, i think this is the best i have been in my life, he said. 

how is the pain? it's there. but i have this new wheelchair and it's totally opened up the world for me. i can go places now, i don't have to sit in my apartment. i may try to take a computer class at the senior center soon. they offer them sometimes.    

i hear you cut your hair?  yeah, i donated it to locks of love. i wanted to give back. i smiled inside, wondering what kind of wig would be made from middle-age, graying, ex-hippie hair.

the attending physician came in. we talked some more, sorted out some medicines, set up follow-up visits.  at the end, the attending prayed with him: god, we thank you for the blessings you have brought in this man's life, for his health, for your grace.

i cringed inside.  blessing? very little of his story felt like blessing.  but he took those small moments - leaving his house without the pain of walking and giving away his hair - as gifts.  and i was humbled...because i know there is sickness in my body too. there are limits and exhaustion and fevers and feeling like i am missing out on life and worry that these little symptoms now could be harbingers of a coming disaster. but there are moments of grace too - people that notice when i need a day off, sunflowers blooming on my walk home, sisters who don't care if you use their popcorn maker, dinners with friends, and patients who remind me to name the good in my life.

on healing

do you think god will heal anyone who asks and has faith? my sister asks me. 

me, who witnesses sickness every day in the lives of my patients.
me, who lived in the nation with the highest hiv rate in the world, who buried friends before they reached age thirty because they were born in the wrong place as the wrong gender.
me, who carries sickness in my body every day. 

if the answer to her question is no, then why pray?

and if the answer is yes, then where have my prayers for healing gone? why do my swazi friends still fight HIV despite their prayers (and lives) of faith?  why does my body still feel like it's breaking even though i have lit candles and cried out, "how long, o lord?"

i don't have an answer for her question. i only have a story, one i re-tell myself in the moments i feel faint:

i met jabu shortly after i arrived in swaziland.  her name means "happiness" and that is what she was.  she got sick quickly though as HIV spread through her body.  she shuffled slowly down the hill as if every step took all that she had.  she seemed to get smaller every day.  soon, she just stayed home. 

i stopped by to visit jabu one afternoon, like usual.  only this time, she was barely moving, barely opening her eyes. her mom stood fanning her, trying to move the heavy african air across her feverish body.  we lifted her into the car and sped across the 30km of curving dirt roads to the nearest hospital.  by the time we got there, she wasn't opening her eyes at all.  her blood pressure was unreadable on the archaic cuff they used to measure it, barely palpable.  the doctor looked at us sadly: we have no beds left. and there is nothing we can do anyway. 

 we begged for them to keep her, knonwing if we took her home, she would surely die.  knowing too that if she stayed, she would still likely die.  the doctor finally caved, offering the floor under the bed of another patient.  we left her that night, her tiny body on the floor under the bed of another dying woman.  chickens walked past her spot on the floor.  a meager bag of IV fluids hung - the only attempt at treatment offered for her. 

the next morning she could open her eyes, and was discharged to home.  miraculously, over the coming weeks, jabu regained strength and life. 
we were sitting on her bed one afternoon, laughing and talking. i asked her what happened that day when we thought she would die.  she answered: i was lying there, and i was flat. i couldn't open my eyes, couldn't speak. but in my heart, i prayed "lord, extend my days." and he did.  i will never forget what the lord has done for me.  

she never forgot. she never stopped praising. one month later, jabu went to be with the one who had heard her prayer and extended her days. i'm pretty sure she's still singing her praise.

why i hate missions

a letter in the mail, penned across an ocean.  i know it is filled with words of grief.  recently, her sister lost.  but her words of loss go deeper: the leaders are fighting with the donors, and they are no more sponsoring our town. 

it was a town imbalanced from the beginning.  built up the sides of two juxtaposing hills, the potential for rifts and separation is always present.  i don't know what happened here before the british colonists, before the asbestos mine opened in 1939.  i do know that the mine owners and skilled laborers built beautiful houses on the higher of the two hills.  and i know the unskilled miners were allotted small mass-produced homes that were packed onto the side of the smaller hill.  those who lived there at the time tell me it was split black and white, with the swazis getting the short end of the stick. 

as if colonialism (further tainted by apartheid spilling across the south african border) wasn't enough, the town took another blow.  the mine closed.  initially only portions of the mine closed.  then in 2001 it completely closed (likely due to the world-wide awareness of the dangers of asbestos). workers were told they had 24 hours to leave. so jobless and homeless, they scattered.  the town was abandoned.  textbooks left in school desks, the night's assignments still on the chalkboard.  hospital wings lined with beds and posters describing treatments for tuberculosis.  houses with large pieces of furniture, dishes, anything that couldn't be carried.

for four-ish years, the town sat empty.  the surrounding villages fell into further poverty, cut-off from the only local economy.  and hiv swept through the country, reaching even these abandoned places with further destruction.

a christian missionary with a vision saw this abandoned town as a place to breathe life into a dying nation. valley of hope, he named it. he relocated several missions groups there: a home for abandoned babies. a church-building company. a school. a clinic. food donations. a continuous stream of short-term mission teams from the united states eager to renovate the abandoned houses to become foster homes.  

it was imagined as a microcosm of good.  but there was fighting. there was racism and elitism that lives in our hearts, that comes out even in the places we are supposed to be loving.  a similar split to the old mining days occured, this time with white christian missionaries in the beautiful houses on the higher of the two hills.  it took a few years, but that organization crumpled.  another one quickly took its place.  this one continued many of the programs already started, and added some of its own, including a dairy farm and bakery in hopes of creating a sustainable economy.   apparently, there is fighting again, and a withdrawal of funds that empties the economy of this mal-developed town.

which brings us to now.  to zandi.  who lived through the closing of the mine. who was employed then unemployed by the first mission organization.  then employed again by the second. who now sits in uncertainty again, yet still fiercely believes in the god in whose name all who have destroyed her town have come. 

i don't know what to pray for this town that has changed my life, to this town that angers me yet taught me hope.  i don't how to end this, so i close the same way zandi closed her letter:

I said in my heart, God will judge the righteous and the wicked,

for he has appointed a time for every matter, and for every work.
-ecclesiastes 3:17

thunderstorms

"what if your blessings come through raindrops

what if your healing comes through tears?"

- laura story

heart cries

"God is within her, she will not fall;
God will help her at the break of day." -Psalm 46:5

lots of deep breaths.

i look at the schedule for the month, and i'm not sure i can make it.

i'm okay at the moment.  four carefree weeks of quenching wanderlust and catching up with friends and sleeping late has seemed to silence the disease that hides within me.

but what about the coming days?

the easy prayer is to beg over and over that i would be well. it becomes compulsive, enslaving, demanding.  the hard prayer is to ask to be sustained, for grace to survive whatever comes - whether sickness or wellness or a chronic state of unwell, for eyes to see the love around me, for a heart of compassion for those in my care. 

and so i wait, and pray, and hope for health, knowing that may not come, and step forward into this new place anyway.

life opening

"for there is hope for a tree,
if it be cut down, that it will sprout again,
and that its shoots will not cease.
though it grow old in the earth
and its stump die in the soil,
yet at the scent of water it will bud
and put out branches like a young plant."
- Job 14:7-9

it started as a couple sticks protruding through the frozen earth.  so unimpressive that i didn't think to photograph it.  so bland that i stuck a hideous pink flamingo lawn ornament into the soil beside it. 

i didn't notice it begin to open. its growth was shadowed by daffodils, irises, and lilies that bloomed around it. 

yet despite my oblivion, it came to life:

it buds.

and blooms.

until the flowers overflow.

and in my heart, i begin to look for those ignored places of life. the ones shadowed by other things. the places that look like dead branches in an unforgiving earth. and i hope and wait for the scent of water to come and bring life.  

naming the good

she dared me to name one thousand gifts.  and i tried. kinda. twenty photos of spring happening in the back yard.  seventy written in a notebook and tossed into the abyss of my purse. 

in a late (and likely delusional) conversation, i told a friend about this list that still sat in the bottom of my purse. what if we each blog about something good each week, she asked.  to maybe try to find good amid the chaos of our lives?

this is for those two lovely ladies:

i was greeted at the door by buzz lightyear.  cinderella came running down the hall, still adjusting her elbow-length satin gloves. their beautiful mother offered the hugest hug and ushered me inside.  buzz handed me a gift bag.  we got this for you, he said.   cinderella was on my lap before i landed on the couch.  i re-introduced myself to buzz; we last met when he was only weeks old.  i told cinderella how much she had grown.  buzz helped me unwrap the gift that cinderella had clearly helped pick out.  she may have been more excited about the candy-flavored lipgloss than i was. 

i have our night planned, their beautiful mother told me. we are celebrating. are you hungry?  the answer is always yes if you just de-planed.  

over dinner, we reminisced about our college days - the people who had touched our lives, our adventures, our friendship. 

we remembered the dark ages of our lives since then. unplanned pregnancy. broken relationships. chronic illness. 

and we celebrated. two beautiful children. jobs that bring life. completed education. triumphs over seeming disasters. resilence. hope. gratitude for our persistent friendship and for the faithfulness of god in our lives. 

a prayer against violence

"We bring to you all who have been affected by physical, sexual, political, and emotional violence.

We pray for those who have died violently because of hatred, mistrust or wanton destruction: 
Heal the violence that may also have battered our souls.

We pray for those who have suffered abuse, injury or death for reasons of prejudice and fear: 
Open our hearts that we may find joy in our differences.

We pray for the children whose innocence and trust has been shattered by sexual predators: 
Give them strength and courage to face the days ahead.

We pray for all who have been survivors of sexual violence:
Heal their shame.

We pray for those whose outstretched hands have experienced only bruises and broken bones: 
Help us to hold them with hands of love and tenderness.

We pray for those whose self-inflicted wounds and for those who do not hear their cries: 
Send them messengers of your grace and love.

We pray for those who are assaulted by words,
Heal them and make them whole.

We pray for those whose lives are lived in fear and dreaded expectation of the next attack upon them: 
Wrap them in your arms of compassion.

We pray for those who have sought love only to find hatred in return: 
May they come to know your unconditional love.

We pray for those who are too angry or too hurt to give voice to their own prayers: 
Bless their anger against you and hear the pain in their heart.

We pray for those who are neglected, abandoned or hungry: 
May they find a safe refuge and a community who will love them.

We pray for the men and women, both young and old, and in between, who may never again know your gift of intimacy because of the violence they have suffered: 
Help them to learn to trust again.

We pray for the families and friends of those who have been wronged for we know they, too, bear some of the hurt, rage and anger: 
Unite them in love that their bonding may become a source of strength.

We pray for ourselves that we may be aware of the violence within ourselves and within the culture we live: 
Help us to return to your path of love.

Most blessed God,  whose will it is for us to live a life free of violence:
We have brought before you this night those who have suffered through the actions of others; those who bear on their bodies and in their bodies the scars of anger and the wounds of hate.
Be with them in your compassion and strengthen them in your love.
Heal the wounds that afflict them and the fears that hold them captive.
Strengthen, too, all families and friends who care for survivors that through their love and support your healing grace may be made manifest.
We pray your blessing upon us who are gathered here and upon all survivors of violence and abuse, especially those whom we have named and remembered this night.
As we proclaim that another world is possible as we pray the prayer of Jesus Christ, who experienced you as:
Our Father, who art in heaven…"

By The Rev. Patricia Sandra Horton, Birmingham, Alabama, USA

things that give hope

i often imagine the worst for what happens to someone when they leave the hospital.  i wrongly assume the point where i meet them is part of an immutable broken path.  

16 year-old girl, second-time pregnant. rumors float that father of the baby is her father too. 

13 year-old boy, bullet-shattered shoulder blade.  step-mom comforts. birth-mom incarcerated.

45 year-old man, heroin-infected spine. discharged to homelessness and a "business meeting." 

i fill in the blanks of their futures along the trajectory of brokenness.  it's easy to do when you see others with similar pasts continuing to live in places of despair.


at covenant house i learned to imagine hope.  

i knew her from the children's hospital.  an infection left untreated too long.  we suspected abuse and neglect.  no family visited her.  i imagined single motherhood. minimum wage or welfare. domestic violence.  then i saw her at covenant house. a step toward hope.  safe housing. job hunting. educational support.  maybe a future of something other than the worst case scenario.  maybe a chance at life.

i knew him from the trauma bay. bullet in his arm; no major injuries.  i imagined another bullet would find him soon enough.  then i saw him at covenant house, struggling to begin a new life.

i don't know what happened after covenant house for either of them. i do know that because of their courage, i am able to imagine things other than destruction and downward trajectories when i see broken points in the lives of the people i care for. 

things that break us

slow steps up to the out-of-the way call room.  i will my pager to stop beeping so i can get at least three hours of sleep before morning rounds.  

danskos slide off my feet as i pull the blanket i stole from 3 West over my tired body.  out the window, i hear a siren.  it is brief, a quick cry, as if its operator isn't sure if the situation is an emergency or not.  my heart sinks, knowing what is next.  pager rings.  

feet slide back into danskos while i walk back down the stairwell.  i enter the code to enter the emergency room, and stumble into the trauma bay.  

beautiful athlete lies on the table.  a small hole in his chest, ringed with a black burn that can only be caused by a bullet.  the trauma protocol has already started as i pull plastic booties up to my knees.  i know the blood will flow soon enough.  

everything happens quickly.  a scalpel. a saw.  soon beautiful athlete's ribs are detached from his body.  blood pours onto the floor as skilled hands search for the source of the bleeding.  a hole in the heart.  staples quickly close the hole but the life blood of beautiful athlete is on the floor and no staple can reverse that.  a defeated trauma team calls time of death for beautiful athlete.  

a large needle is placed in my hand.  med student, sew him back together.  a baseball stitch will do.  impatient nurses hurry me along as i imprecisely reattach ribs to belly.  the skin under my stitches will never heal.  i stitch simply so his family can see him reassembled. 

a final knot is tied.  again i trudge back to the call room, again i will the pager on my waist to silence.  inside an open door i see beautiful athlete's family listening as trauma surgeon tells them the news.  i feel petty for craving sleep while beautiful athlete's mother grieves the short life of her 22-year old son. 

local newspapers never give details of the shooting.  simply name and age of beautiful athlete, and the cross-street where he took his last breath.  

at home the next morning, despite the overwhelming exhaustion, sleep will not come.  over and over i see my stitches, running like a baseball, across beautiful athlete's chest.  i wonder what hope looks like in the face of street violence. a fatigued grasping for meaning, i google some variant of hope, street violence. the first hit brings up words written by paul two millenia ago: i am convinced that neither death nor life...can separate us from the love of God.  my eyes flood with tears.  i hope desperately that this is true.  

in the retelling, a friend offers words of comfort. maybe your stitches were part of the redemption of the world.  maybe, if we believe our bodies are raised someday, it is your stitches that made him ready for that day. 

a chart review

i know her name.  
i know her age. 
i know she came to the hospital to have a baby, and she found out she had HIV.
i know they sent the hospital social worker to see her, to see how she handles the news.
the social worker's note documents tragedy. 
father of the baby died 4 months ago.  (street violence?)
two more little ones, ages 1 and 4 at home. 
year-old babe should get HIV testing.
patient's mom and stepfather died in the past year.
no other social supports. 
patient seems depressed...is she safe to take home this new life?

the babe's chart is somewhere else, but i remember the hospital's collective sigh of relief when he came back negative for the virus.  

i know all these facts. but i don't know her. 
i don't know the joy she feels when her new babe wraps his hand around her finger. 
i don't know the agony of figuring who gave her an infection science has only figured out how to suppress but not cure.
i don't know the guilt that builds, realizing she could have passed the virus to this new life.
i don't know if there is anything in life that has made her resilient, that gives her hope, that strengthens her in the face of these injustices, if there is a god she clings to.  

i hope for her.  
that someone would come alongside her in this now increasingly difficult journey. 
that year-old babe would be virus-free. 
that echoes of hope, bouncing off unknown walls, would strengthen her soul.  
that she would know she is loved. 

and, as always, that hiv would end.

from far away

it's difficult to be distant from places of suffering, to know a close friend is grieving the death of a sister on the other side of an ocean, to know that in a world where i wasn't sick myself that i would have been there already.

i know how the funeral will go.  it will start at midnight.  it will be dark; the family's homestead has no electricity. the dim light from candles will shine through the windows. no streetlights will lead the way to the home.  the milky way will hang overhead but offer little light. everyone will gather in the main room; the casket will rest in the front. the voices of those grieving will escape through the door - singing songs of praise to god.  just before the sun rises, the singing will stop.  a pastor will speak a eulogy.  friends and family will read pieces of scripture.  precious in the sight of the lord is the death of his saints.  i am convinced that neither death nor life...can separate from god's love.  the singing will restart as the room empties, and will continue down the winding road to the malanda cemetery.  the pallbearers will dig a hole as the rest of those grieving collect rocks from the side of the mountain.  the sun climbs over the edge of the mountain.  the singing remains. there is no one like jesus. i walk, i search, i turn around, but there is no one like him.  the casket is lowered into the ground, and earth covers it.  the collected stones form a pile, marking the grave.  and then those grieving sing their way back to the house where they feast and celebrate the life of the lost. 

across the continent of africa, the sun rises over those grieving the lives hiv has taken.  funeral directing has become a lucrative business as the death rate soars.  and we wake up this morning to yardfuls of easter eggs.  i wonder what it means that jesus has risen.  i wonder what the good news is for the continent of africa.

i light candles and send my SOS's to the heavens, begging for hiv to please end soon. 

a message from swaziland

"The global HIV/AIDS epidemic is an unprecedented crisis that requires an unprecedented response. In particular it requires solidarity -- between the healthy and the sick, between rich and poor, and above all, between richer and poorer nations. We have 30 million orphans already. How many more do we have to get, to wake up?" - Kofi Annan

it's good friday. 

i figured i would think about death at some point today.

a message from an expat in swaziland is my inbox when i wake: zandile's sister died this morning.  she collapsed and died as they arrived at the hospital.  she has two girls, now double orphaned.  they are surrounded by strong family.  zandile will cherish any words you send.  are you coming soon?

i pick up a sympathy card at a christian book store.  i know zandi deeply believes in god.  buying the card is an act of faith for me. asking god to surround you with his love, it reads. 

to get to the card section of the store, i walk past a series of book displays: so long, insecurity. fat-proof your family. lady in waiting: what do to while waiting for mr. right.  my stomach ties in knots.  two more children are orphaned in swaziland, adding to the other 100,000 across the nation.  none of this is represented by any of the titles i pass. 

now i sit with this card that wishes god's peace to my friend who just lost a sister and added two children to her own three.  what to say? my eyes flood with tears.  i'm deeply sorry for your loss.  i hope the peace i struggle to find in my own life may be overwhelming present in yours.  may your land produce enough food to feed two more mouths.  may there be money to pay their school fees this year.  may the god who claims to be the father to the fatherless be that to your two new children.  may the HIV that hides in your body be restrained by the medicines the swazi government graciously provides you.  may you live long and well.  may you not leave your now five children orphaned.  may you know you are loved. 

and may hiv please end.  soon. 

an introduction

i've been told over and over, "you should blog these stories."  these stories meaning...the stories of working at an urban hospital. the stories of being a medical professional and having a chronic illness.  the stories of hiv in a developed nation in 2011.  the stories from a life in swaziland.

these stories of my life seem incohesive and scattered. the common thread is a struggle to make sense of the tragedy and joy around me. to acknowledge the doubts and to somehow believe there is hope. to maybe even see god.

so for everyone who has encouraged me to blog these stories, this is for you.