every answer, to every question

“When one must, one can.  When one knows why, one can endure any how.”  

– Chinese Proverb

            It was almost two weeks ago that my plane dipped down beneath a low ceiling of clouds, landing in Eldoret, Kenya.  It had been a tiring trip – four flights with fourteen hours of layover time across three continents and over more than nine thousand miles.  I had met several interesting companions seated beside me throughout the journey, with whom hours of interesting conversation took place: a sixteen-year-old Dutch girl returning from school abroad; a retired Greek Orthodox Bishop traveling to Europe to baptize newborns; a Nigerian Colonel, Defense Advisor to the United Nations; a retired mental health technician about to adventure on safari in the Serengeti; Senior Epidemiologist to the Tuberculosis Foundation, operating out of Addis Ababa and Nairobi.  I obviously slept little and listened much.

            As we entered our final descent, I reflected on the year prior.  How many days and nights passed, wondering if the day would ever arrive?  How many hours had I spent staring at photos of the children, wondering if I would ever have the opportunity to hold them again?  How many times had I uttered, “Please, Lord, if it be Your will, would you let me go back there and take care of those children?” How many times did I close my eyes at night and awaken hours later having spent all my dreams thousands of miles away?  How much time had I spent daydreaming of children who had forgotten me the moment our matatu drove off?  How many ‘Dear Jesus’s and how many ‘Amen’s? How many moments did I sit alone in my apartment, scrunched up like a ball, my head to my knees with my arms wrapped tight, begging God to allow me to return, or to remove the desire?  How many heartbeats felt misplaced away from these babies?

            A few. Several. Many. Countless.

            The morning sun cut through the clouds and a dazzling eruption of light poured down from the sky as our plane was just approaching the airport.  I spend a lot of time looking up and it was like nothing I had ever witnessed.  A deep and enveloping warmth wrapped around me and I knew I was accompanied by the Spirit of God.  There was another sense that accompanied me, though: the hint that Something was coming; that experiences beyond my imagination were inevitably hurling toward me through time and space.

            My bags arrived intact and undamaged; more importantly, so did the two remarkable young gentlemen who were kind enough to pick me up at the airport.  You’ll hear of them again – Ray and Adam – two of the five other long-term missionaries who live here at In Step.  After breakfast and a morning of errands in Eldoret, we headed home.

            Yeah, I said it.

            If it is truly where the heart is, then this is mine.

           

            The kids welcomed us warmly, and I had to laugh – they thought it was Carla (another one of the five, the female director) returning from her visit to the States.  A few of them remembered me, which was more than I had expected.  I got a warm welcome from James (six) and Churchill (eight) and we exchanged a few Swahili phrases.  There was a room generously prepared for me.  I quickly put my things away and then…. Well, then, it seems to have all been a blur until this day, as I sit here at the edge of the compound on a Sunday afternoon, questioning the sky as to how long it will take in its consideration of breaking open its dark blue clouds I see approaching in the distance.

            The next thing I knew, I was handed keys: ones I literally dreamed of someday carrying.  A single skeleton key now mine would predict my activities for the rest of my time: “This is to the med room.”  The other handful contains more in promise than in practicality, today: “These are all for the clinic.”

The Dorm

The Clinic

            I can’t tell you what I did next.  Did I walk out to the veranda to see the children eating lunch, seated at the long wooden tables, babbling and yelling in English and Swahili, turning their precious faces to see the new mgeni (visitor)?  Or was it then that I walked out to the clinic, to see windows and doors in place where none had been before? To hear about their challenges with this and that (something about an electric meter, and a water tower, maybe)?  Or was it then that I was literally stunned to see the incredible progress made on the new dorm we had worked on the year prior?  Here I was: back. Feet on Kenyan soil.  In Step soil.  The hour of my dreams, waking and sleeping.

kids on the veranda

            The sentimentality was necessarily curbed at that point – I came here because I feel called to do the work.  I don’t believe God called me here to gaze admiringly over the African landscape and cater to my imagination; I feel throughout my spirit that it is in the small tasks of everyday life here in which the most profound beauty, by way of the Presence of God, is revealed.  This will be easier to explain if I describe what my days have looked like, generally, since I arrived.

            My day starts early, around five-thirty, when the children are getting up and bathed, assisted in preparation for whatever their days hold.  I’m up so early because it’s my job to make sure that the handful of children who need their “ARVs” (as we call them, the anti-retrovirals) get them on time.  Some take a few pills before heading off for a long and intensive day of school, while others just barely stand up in their crib while I hold a medicine cup of pills put into solution up to their lips.  All it usually takes is a general suggestion of “kunywa dawa” (drink medicine) for them to sip it down.  Other mornings I hear, “______ amelala,” as I am informed that the child is still asleep; a few peers are then seen scampering to their bunk and escort their tiny friend, then staggering sleepily in pink and yellow patterned pajamas, to me.  I see their precious eyes looking up at me from the height of my knees, sleep-crusted at the edges, as I divert the uncorruptible smile of an innocent baby when I instruct her to sip her cup of Abacavir.  It is in that moment that time tends to stop while I feel my heart about to burst with love for these little strangers.

            Morning med pass usually happens at breakfast: I prep everything in the med room in cups I’ve washed and cleaned by hand (not so easy to come by here).  I consult an Excel spreadsheet that Ray expertly programmed – every child has a page containing their history and medical visits; when medication orders are entered, dates and remarks in certain columns trigger a reordering of the master list names so that all the children who need meds for the day are brought to the top and highlighted.  I can even clearly see who needs injections for the day, in advance.  This type of organization was more than I expected and hoped for – it helps me do the three main med passes of the day with ease, and undoubtedly increases medication safety here.

            I find myself in the veranda at breakfast time, tray of medicine cups filled with substances of various colors, each labeled with a name, and I’m on the hunt for who’s who.  In a room with more than one-hundred-and-twenty children, with very similar features and almost identical hairstyles per gender, I quickly discovered a challenge in “patient identification”.  I usually ask three or four people (the kid, if they are reliable, and a few classmates plus a few staff) the name of a child until I am sure of who they are – kids like to play jokes with a newbie like me, and there’s also a language barrier that’s sometimes a problem.  The children are usually compliant.  The babies, however, are a different story.

            I have very little experience in pediatrics.  I took care of kids, and otherwise sick people, but never sick kids on a regular basis.  Here are a few things I learned:  babies don’t like to eat anything that’s not formula or a foreign object; you can trick them if you put their medication in the nipple of a baby bottle; if they cry too much when fussing about taking the medicine, they will vomit on you if you’re not careful; the only baby who wants to take the medicine from my hand is the one for whom it is not intended; and prepare yourself to be subjected to an array of bodily fluids at your next med pass.  Also, many of the babies are used to being fed by the Kenyans, and having a mzungu (white person) strongly encouraging them to drink a curiously unidentifiable and unpalatable substance is, in the least, alarming.

            My clothes are usually soiled by then.  The kids who have eaten get up from the table and hug me, their hands and mouths dressed with remnants of food or chai (tea).  I learned that a burp-blanket would come in handy after one of the toddlers with cerebral palsy spit out his cod liver oil all over the top of my shirt (use your imagination).  At some point after ARVs or general morning meds, I get to have my own cup of chai and a bowl of cereal and hang out with Ray, Adam, and Beth Ann (another one of the five, the preschool teacher) while we complain about politics, discuss plans for the day, and mercilessly make fun of each other (a never-ending source of entertainment). 

            A few days ago I started a new morning tradition at breakfast – ringworm treatment.  Many of the children have ringworm on their heads (tinea capis) and this very contagious, very common fungal infection, is easily treatable.  (Ringworm is the common misnomer, as it is not caused by a worm, but is instead by the same fungus which causes athlete’s foot) We have plenty of antifungal cream here – the problem is getting it on all of the kids regularly (twice a day, I try for) where it is needed.  As unpleasant as it might seem, the best method to the widespread application of clotrimazole cream (what we have available here that is affordable and effective) seems to be while they’re eating, since most of them have it somewhere from the neck-up.  They look over their shoulders at me and say, “Miss Julia! What is that?!” and I say, “dawa for your shilingi,” (medicine for your ringworm).  Most of them usually get up from their seats and shout, “Na mimi?! (and me?!) Julia! Na mimi apa! (and me, here)”.  I go through at least one-and-a-half tubes of clotrimazole per morning. 

During the morning hours before lunch I’ve been making time to do chores, monitor med room inventory, keep track of who needs to get tested for what (usually new kids need tuberculosis and HIV testing) or who needs immunizations.  A few times there’s something to do off-compound, (and I could write entries on the exciting happenings of each episodes, trust me) like going into town with Adam to the pharmacy to pick out something special needed for one of the kids, or going to the “dispensary” where the kids get vaccinated, or heading into town to Kitale District Hospital with the social worker to get chest x-rays for the few tots who still need TB screenings.  Lunch med pass is usually light. 

Almost every afternoon Ray (or Adam) and I take a few kids into Sibanga (ten or fifteen minutes away) to go to our local clinic for a visit with the doctor or nurse [practitioner].  Usually at least one or two kids will have been brought to me by an auntie (what we call the local women who are employed to provide most of the direct childcare) with a fever, GI complaints, or malaise.  (I could expand about the clinic experience, I’ll go on about that another day)  Most of the time it’s malaria, and they are started on intramuscular, and then/or oral antimalarial medication and PRNs (medications as needed) for fever or body pain. When we get home around four or four-thirty there’s some time before dinner med pass, and then I usually eat dinner with Beth Ann and the guys, and sometimes Carla and Jeff (the last of the five, the male director, Carla’s husband), before our evening devotion and prayer time.  By the time we’re all done chatting, joking around, decompressing from the day, and praying, it’s usually after eight and we’re all exhausted.

            It would be strikingly unrealistic if I told you that the routine I just outlined is the standard flow for my day.  Yes - making sure the children have their medications on time is my priority.  However, on any given day, a hundred unexpected issues surface, a portion of which fall to me.  I’ll give you a few examples.

            Last Saturday morning, as the kids were doing their chores in the morning hours, I discovered that many of them like to run around barefoot.  I reminded them, “mevaa viatu vyako!” (wear your shoes!) as I removed a few splinters and thorns, cleaned off and dressed wounds on the bottoms of their feet (one of which was infected and oozing pus – that one needed a bit more work).  Then another night one of the little boys took his dinner spoon to the head of the boy sitting next to him and gave him three deep abrasions on his head – sprinkled with rice from the spoon, of course – to show for it.  Another one fell, another gets stung by a bee.  This one has a rash, another one hurts to pee; this boil, that scrape.  Kids get into everything imaginable!

“Miss Julia, this itches.” 

“Julia, my shilingi.”

When it rains here, it pours.  I mean this proverbially as well as meteorologically.

When I first got here almost two weeks ago, I took my keys to the med room and started up on day one.  I’m not sure if this was wise, considering I was critically low on sleep, but it happened anyway and we got through it.  A few days in I really started to hit a wall.  There was a honeymoon period of a few days but then it wore off quickly and I felt like I had thrust myself into the fire – jumped head-first into the destiny of a job I had been fantasizing about.  In all my dreaming and praying, I had refused to allow myself to become preoccupied or worried about what it would “be like” to “be here”.  I just focused on what could be done at the time to prepare, and move forward in that direction.  By the end of the first week, my prayers looked different. 

I felt it creep in one morning when, during morning med pass, before I had even had breakfast, when four kids had been brought to me with various injuries and problems, and the brave young tyke who just spent four months away from home getting scalp reconstruction (will tell more another day) pulled her dressing off and then her raw and sutured scalp was exposed and I needed to redress it (is delicate and involved and takes a while).  I hadn’t been sleeping well and had been waking up as exhausted as when I went to bed.  I was busy thinking about that one child who didn’t seem to be responding to the antibiotics I was giving him, and the other one who seems to be having an adverse reaction to his eye drops.  I was my mind was pulled into wondering if I was doing enough for that severely malnourished infant we had been entrusted to care for just a few days prior.  And what about that staff member whose malaria just keeps coming back, does he have a strain we aren’t treating properly?  I hear behind me, “Julia!” and I feel three or four pairs of arms wrap around my legs.  In that moment I was experiencing the fact that sometimes, just saying “kunywa dawa, tafadhali (please)” just doesn’t work as one of the babies thrashed his head back and forth while I tried to medicate him. The next second I’m wondering if the chai that other baby is drinking is going to interfere with the medication I just gave them. Then I felt my throat itch and the tone of my voice change – I was losing my patience and getting frustrated – and breakfast wasn’t even over yet.

I heard a thought run through my mind like a bandit and I was afraid to acknowledge what I heard between my ears.   It troubled me.  I thought, “this isn’t what I’m supposed to be feeling here.  I dreamed of this.  I prayed for this.”  I took a breath and walked away from what I was doing to regroup and focus.  I looked out the window at the children now playing in the yard and heard the words come out of my mouth.  “Can I do this?”

 When I say that I hadn’t previously allowed myself to imagine what it would really be like when I was here, I mean specifically.  I knew it was going to be hard.  I knew it would challenge me beyond anything I could imagine at the time.  I knew I was walking into a field in which I had virtually no experience: pediatric tropical medicine in a resource-limited setting.  That changed prayer is what got me through the rest of the week, and the following one, and what has brought me to this day.

“God, please help me to do my best to do whatever You need me to do today.  Thank you for getting me here.  Please help me to take care of Your children.”

It’s hard.  Of course it’s hard!  Really though, it’s not that bad.  Just when it gets hard, I look down at one of the kids I have the privilege of taking care of and their big brown eyes fill my heart and seal up any cracks in it and I go do whatever is next.  I work with an incredible team of long-term missionaries who go above and beyond, every single hour of their day, thanklessly doing their own work and still helping me with mine.  They’ve been really helpful especially since I decided I would take on another job since I came –  in addiction to the nursing gig I’ll also be moonlighting (or day-lighting) as covering “Hospitality”, being responsible to make sure we are prepared to host teams and visitors and doing whatever is needed to get ready for them.  I pretty much hit the ground running, out of the frying pan and into the fire, since I got here, and I don’t expect it to slow down even a beat.

These past two weeks have forced me to come face-to-face with myself, reflected back to me in the angelic expressions of these babies formerly known as orphans.  I have had to stare-down a few of my own vices – the tendency to lose my patience, the habit of thinking negatively, second-guessing myself endlessly, imbalanced confidence, the challenge of getting too far ahead of myself.  I’ve had to accept a startling and disturbing fact that I was terrified I would discovery, and horrified to admit.  It’s the answer to the question I asked a few paragraphs ago, a few weeks ago, a few days ago.  It’s the answer to the question I ask myself when I wake up every morning.  “Can I do this?”

No.

No, I can’t do this.

No, I can’t do this.  I can’t be a nurse to one-hundred-and-twenty-nine kids here, in a country I know nothing about, with diseases I know nothing about.  I’m not a pediatric nurse!  What do I know about malaria?  Or tuberculosis?  Or HIV?  What do I know about this baby or that one?  I’ve been a nurse for just a couple of years!  And I’ve never even been a mother, how do I know what to do with a baby?  God, are you sure You’ve got the right woman for the job?

I never thought there could be so much freedom in one word: “no.”  It’s the most incredibly joyful answer to a question I could have ever asked myself right here, right now.  Can I do this?  No.  Of course I can’t.

But God can.  And He is.

As soon as the challenges have come over the top of my head and I realized that I couldn’t take it on myself, and I reached out to God through prayer and faith, was when things started to make sense.  Of course I can’t do this.  It’s not something one human being can take on alone.  What God’s Grace has helped me see in the past week or so is that it is only through His assistance can the impossible be made possible; He makes us weak into strong and capable people; He gives the fearful courage; He heals the broken and rescues the lost.  He has proven His love and help to me countless times – He did it by bringing me back here – and now he continues to everyday that He allows me to do even the smallest task for one of His kids.

I believe He brought them here, each and every precious one.  When I keep my eyes on Him, and then on Them, these children, everything else falls away; the worries disappear.  I can’t explain what happens when someone comes to me with a problem I don’t know how to solve and then they walk out of the med room with a smile on their face, and I feel like I’ve just had a visit from an angel.  Even just walking around the compound from one task to the next, and I hear a child’s confused happiness over their ringworm disappearing, “Julia! Where did you put my shilingi? I can’t find it! It is missing!”

I hope I can never do this.  God is the one who can do this.  And what happens through God is universes more than what I could ever try and do by myself.

He is taking care of these kids.  I just pass a few meds, tag along for a few clinic runs, and put Bandaids on a few scraped knees.  I am just one inexperienced woman with an eye for long words (like art-em-is-in-in and keto-con-izole­ and ne-vi-ra-pine) who fell in love with a group of children in a lonely corner of Africa.  It is in God’s heart that a love for children, who were no more than strangers to me, is born.  It is God’s strength, God’s patience, God’s hope.  I say this from my own experience, and because I cannot explain what happens in my life on a daily basis in any other way.  Every day I ask for the ability to do what I have been shown I cannot.  Every day I am shown how to do things I could not do the day before – and sometimes I only discover it is possible once it has been completed.

After a long and challenging week, it is in God that I rest.  We all did a lot this week.  One night a couple of us stayed up late to paint the boys’ room in the new dorm so they could move in this weekend, and last night they slept there for the first time.  One of our boys ran away from home and is now in jail; a child making adult choices.  HIV results are still inconclusive on another child and we’ll have to take him to the specialists for them to sort it out.  We have a work team on their way to us as I write and we’re all looking forward to them bringing their passion and gifts to the children.  I have plenty of chores to do this evening after I’m done writing this.  Three of the six of us are heading to Nairobi this week to sort out some stuff with work permits and to try and get my nursing license figured out.  It’s a lot. 

It’s through this lot of work that God shows up at every turn and proves His Heart to us.

Today I wonder how many challenges I’ve encountered and how many joys I’ve been blessed with to match them.  Since I’ve gotten here, how many hugs have I been given?  How many have I been able to give out?  How many kisses on the forehead and how many “lala salamas” (good nights)?  How many pills in how many cups that I’ve washed and washed and washed how many times?  How many bandaids on how many scraped knees?  How many raspberries have we splurted on how many babies bellies?  How many heartbeats marched out the most unbearable love I have ever known, for the most precious children in any country on any continent?  How many bottles of medicine have I gone through?  How many “Miss Julia!”s did I hear?  How many babies’ cries, and babies’ smiles?  How many moments carved out of destiny, overflowing with God’s grace, were we all blessed with here this week?

I ask these questions not because the quantifiable amount matters.  I ask because it is in every task, at every turn, however challenging, however frustrating, whether mundane or extraordinary, that God’s power and love flow down on us. 

I ask because God is the answer to every question inside of me.  I have questions about my life far outside the scope of this discourse that I can only barely begin to ask and I do struggle with some of these on a daily basis.  Whatever the question, though, He is always the right answer.  It is through finding the right Answer over and over that I have learned to ask a better question.  I don’t have to ask, “can I?”  The question I could ask is, “Can God?” The answer to which is profoundly evidenced here, ever-proven to me in the life of every child, every day.  He is all the answer I ever want to ever need.