Ethiopia, Kenya and Freedom

So I take about 2 months between blogs, ... what's it to ya. Been catching up on my reading, ...moving Jule into her new digs on Temple's Campus...spent 4 weeks out of the last 8 on airplanes.....its been a busy time. In fact, 2 of the 4 weeks on the road were spent in Ethiopia and Kenya. Told my wife I'd be home for a while. She didn't believe me,.. and rightly so. No sooner than the school year ended, I was invited to join a team traveling to Ethiopia and Kenya to assess 3 hospitals for the Pan African Academy of Christian Surgeons. This is a training program aimed at reducing the "brain drain" of surgeon from these 2 countries so in need of retaining well trained medical professionals.

So there I was in Soddo, Ethiopia, Bomet and Kijabe Kenya.... On and off planes, little or no sleep, a plethora of lodging accomodations and unreliable electricity, but then I'm not complaining,...No need,....I live an amazing life,.. I get to go where I want, when I want, with whom I want,.. talk about freedom,.. GSK was never like this. But I wonder,.. is the freedom that all of us have, worth the cost, or the trauma of what is revealed to us. Freedom indeed has its costs,.. freedom to use our resources, freedom in how we spend our time,.... We are allowed to witness many of the horrors of life, horrors we see everywhere,.. if we keep our eyes open,... and sometimes,... even if we don't.

David was following the medical team from bed-to-bed-to-bed,... head cradled in his hands, ... a look of despair that 100 family deaths would be unlikely to rival. But this man of about 35 was following us as we made medical rounds at Tenwek Hospital in Bomet, Kenya as if his life depended on it,.. and in large part, it did. His wife, mother-in-law, and three of his children had been in an horrific road traffic accident. These individuals represented David's life. They were traveling on a bus that had overturned and collided with another vehicle causing several fatalities. In order to save their lives, David's wife, mother-in-law and two of his young sons needed left arm amputations, and the other son, about 3 years old, sustained a severely mangled left arm and hand. And David, who was not traveling with them, .. well,.. he gets to watch his loved ones suffer through this tragedy. But David is suffering too. What do you say? What is there to say? Freedom has its costs. We can seclude ourselves in our homes and offices, (or Churches for that matter), or, we can be with David. We can suffer with him. We can pray with him and for him. So the question, I suppose is,..do we want that kind of Freedom?

Road traffic accidents in Kenya are the leading cause of death in that country. David and his family are just one example of the traumas of this daily experience suffered by so many. On the way to Tenwek for example, we witnessed a car that had careened through a guardrail down a raveen of the Rift Valley. ... A daily occurrence for David and so many others. Add this to HIV, malaria, tuberculosis,.. you get the picture,... a recipe for disastrous quality of life anywhere on the planet.

If we choose to use our freedom of taking the poor into our hearts,.. as they suffer, it will cost. As our hearts aches, can we handle the pain? David's heart needs to be held by ours.

Vulnerability,.." I'm Joe Pitts"

Been a longtime between blogs,... but life has been hectic in recent weeks, professionally and personally. Its taken me to L.A. this week to visit with my Uncle Joe, my Dad's youngest brother. Visiting here with my brothers Derrick and Isaac trying to help Uncle Joe with personal and relational affairs, but far be it from us to help this active, independent and autonomous, in spirit anyway, 90 year old with anything. Still, he's showing signs of decline as many 90 year olds do and its hard to witness the slow but steady and certain reduction of autonomy, and, I'm sure, far more difficult for him to release it.

"I'm Joe Pitts", he defiantly stated during our somewhat hectic exchange that had included a visit from paramedics responding to the alarm that mistakenly was triggered by his medical emergency "necklace" while bathing. I had expressed concern, as had his children, that he might fall while trying to maneuver in the washroom. "I try to tell everyone that I'm not going to fall. "I know how to fall without breaking my hip. " I'm Joe Pitts."

It was in that moment that I understood, the horror for this 90 year old man, who was faced with the decline of his own mobility. It was that vulnerable moment that shouted the palpable fear he must feel that others must come to his rescue when confronted with weakness in what had been a strong and free life. How strange it must be for him to release his grasp on independence, to appear weak,... to appear less than able. What must this say about him? Can we even begin to imagine? My soul screams NO!...But in the sadness and joy of this sharing this moment with my Uncle Joe, my heart says we must.

Earlier in the evening, he had asked me how I was doing. I responded that I was doing ok, with the usual aches and pains of an old guy. Knowing I was talking to a 90 year old and that he would laugh, he predictably snickered that I didn't know what 'old' was. He and I actually have a good time together and can talk jokingly about such matters. But he was right, of course,.. given the context of the moment, I don't know what old is. Then as if to underscore this conversation and give me some hint,...some brief tutorial and preview, the episode with the emergency squad happened. The Universe does indeed have a sense of humor....and the joke's on us.

We stare at our vulnerability constantly. If we're lucky, it smacks us for our attention, and shows only brief respites between screams of our names. But classically, we deny our eventual demise, seeking immortality in materialism, perishables, children, family, even as we ourselves perish. Not that this is bad, but the key might be not to let these things take precedence over our consciousness about where we're going. What is our path and where is it taking us? How do we handle that ultimate anxiety, our vulnerability.

Joe Pitts is not unusual, I bet. Pushing back at vulnerability is a ubiquitous, human condition. None of us wants to feel weak, or unable, or afraid. But we are all of these things.

Several months ago, through events I'm still struggling with, I came face-to-face with my vulnerability and mortality. Its not pretty, but I'm thankful for these events..... my rude yet very much needed awakening. So I'm one of the lucky ones. But so are we all. If we are already paying attention and sensitive to our vulnerability, the awakening, can be reduced to just a reminder. A reminder that our lives can change in a moment. a moment that can cause dramatic renewal, a moment that can bring about enormous clarity. A moment that can birth understanding... even if the birth is that which you need to understand and explore further. On the other hand, if you're not paying attention, .. well, its time.

Paying attention to your vulnerability is not necessarily a bad thing.... it will change your life.

So, the next time you feel frail or vulnerable, weak and afraid,..clinging to your independence and autonomy,..the next time you feel close to your vulnerability, you might think of your Uncle Joe..... I do.

It ain't all bad,..... looking at our healthcare blessings

Had an MRI today,... yep, .....laid down,... I.V inserted.,.. mask,... slid in the tube,.... the works,.. takin' a look at the ol' noggin,.. makin' sure everything is stable in there (and all without Ativan). Of course, this is a great time for me to be analytical,.. or is it critical,.. of the health care system as we know it.

If your in the waiting room of a hospital radiology department, or another department for that matter, ..seems that confidentiality is non-existent. Of course, this is a key tenet of HIPPA. But all those in the waiting room this morning know each other's names, .. not by exchanging pleasantries with each other, but by having our names shouted by the receptionist, when it came time for us to register. If you listened carefully, you could find out ages as well,... just do the math when the patients birth dates was asked,.. all in the waiting area. No big deal to many, but suppose the patient, well,... just doesn't want that information known.......Too late for that,.. I think "the cat is out of the bag". The background music, if there is any, just won't compete with the volume of the receptionist pleasant and dulcet tones :-). Oh, by the way, no curtains or private areas once your actually seated and talking to the registrar in the cubicle, so better talk in hushed tones if you really want privacy. But I say, it would probably be more honest if they use mega phones,... Sorry,... getting a bit cynical.

But even the skeptic in me admits that these individual sit and toil daily in order for me to have access to technology that could save my life. We often sit in judgment of the broken system that defines health care these days, but the individuals in the system are really doing a yeoman's job at being the glue that bond us to this system. As broken as it is, it works. Slowly at times,.. cumbersome at others, and more frequently than not, its frustrating. But it saves lives. And as much as we complain, our health care system has the power to deliver services that can't be found anywhere else in the world. The registrar in the cubicle provides entry to these services. I'll have at least some clue of what my tomorrow will be, or even if I'll see tomorrow because that registrar let me through the door to some of the most advanced technology in the world. So there I was in this tube called an MRI, for 30 minutes, my anxiety lifted and,... I took a nap. An over simplification? Maybe. But I thank this broken system and the registrar who told everyone my name and age, for allowing me through the door. Most of the world can't say that.

And there's more. After we were done (me and Tonto), we walked a mile,.. not on the track,.. not at the gym on the treadmill, but in the hospital. This hospital has arrows on the floor of their corridors, that actually mark off mileage,. a pretty cool thing. You can get an MRI and walk a mile,.. or two, afterward.. They're moving toward full service, one stop shopping in health care if you ask me.

So the next time you're tempted to complain about the U.S. health care system, stop and think. You have access to a system that, simply by being born here, insures that you get your three score and ten (if you want it),.. and often, more. And if that doesn't cheer you up, next time you're in a hospital, if you can, get those endorphins moving by going for a little walk.

Gratitude,.... now that's what I'm talkin' about

Michael Bernard Beckwith talks about gratitude in an infectious way,... kind of makes you want to go out and catch whatever it is that he has. What do you think? Read on:

"When I first wake up, I wake up in a field of gratitude and thanksgiving. I’m just very grateful to be awake and aware and alive, in an attitude that allows me to see differently. When I’m in gratefulness, when I’m in gratitude, then I can’t vibrate on worry, doubt and fear. And I cannot live in the future as well because gratitude is now.

"So that’s the first thing I do. And then I will say something along these lines: “I’m available to more good, more love, more wisdom, more knowledge, more joy than I have ever realized, experienced, imagined before in my life.”

"I throw myself open by saying that.

"I’m now available to more good, more love, more peace, more joy – whatever the qualities are that I’ve ever experienced, realized or imagined before in my life – so, I’m on now a precipice of becoming more myself. So, I’m not living on yesterday’s laurels.

“I’m available to more good than I’ve ever imagined to come forward in my life and I’m not under any delusion that I know what that good is!”

"I’m not under the illusion, and I haven’t defined what that good is. I’m just available. I’m grateful and I’m available. Now, transformation can occur.

"And we always know it’s transformation because it surprises us – and if it doesn’t surprise you, it’s not transformation. It could be something that you’ve expected and put together in a nice, little, neat package.

"But when you throw yourself open by asking empowering questions and by willing to be more than you’ve ever thought you could be, you get surprised by the depth what’s inside of you!

"It’s so potent that it’s oftentimes shocking.

"You have to be prepared to free flow – what I call “free fall” – and surrender to the good that’s beyond what you can even describe. And so, a lot of the spiritual work is really about moment-by-moment preparation, to release the illusions of what you think makes you happy, to move into being a giver and a sharer of the Divine."

Re-arranging the furniture?

So,.. if the Japan earthquake and consequent tsunami happened just around the corner, just how connected are we? I've been reading about geologic matters recently,... you know, plate tectonics, subduction, convergence, divergence, continental and oceanic drift and all of that. Turns out that our globe is constantly on the move. We are in fact, in very rudimentary terms (because I don't pretend to understand it all) floating on a mantle that carries us from one place on this globe called earth, and delivers us, over time, to another place. And guess what, we have no control. Zero. Its almost as if we're in an eternal game of continental bumper cars, over say... 4.5 billion years? And what's amazing about all of this. is that the underlying processes literally do mean that although our continents reside on different "plates", our worlds constantly collide with each other, in ways that are sometimes unexpected (remember the movie Crash). Earthquakes are but one example, but we are connected,.. not only in human terms, but in eternal, geologic ways. Connections that are inextricable, about which we speculate but cannot eradicate. Yes, we are joined at the hip or at the geologic trench, rift or plate, if you will. The late famous astronomer Carl Sagan has said that we are " star-stuff". That's actually not an abstraction, but it can be difficult to place into the context of the here and now. We could also say just as emphatically that we are "earth stuff". Connected undeniably and irrefutably... on this planet,.. here and now.

The Japan disaster reminds us of our vulnerability and fragility, but should also remind us that we rent this planet. For 2 to 4 million years (depending on your reference source), we have developed as a human species, created civilizations, empires, cites, etc. We've constructed, destructed, multiplied, gained possessions, recycled, gained more possessions and arrived at our present state. All of this, on a planet that we rent, but that lives, literally, beneath us, and that controls our daily existence (If you don't believe this, then checkout tomorrow's weather forecast). So if the owner decides to remind us that we are tenants, by rearranging the furniture, should we be shocked?

We are surprised because of the toll in human suffering. Because of the calamitous nature of the scope of destruction that has occurred, we are horrified. Indeed, human suffering is cause for concern and sadness about the plight of our neighbor. But are we also horrified because of the movement of the furniture that we think is ours? We've furnished the apartment perhaps, but maybe the owner doesn't like the arrangement. Perhaps, there's a reminder in this that thinking and priorities need to be re-examined, if not re-aligned.

Just food for thought, but for the 4.5 billion years this planet has existed, earthquakes and worse have occurred. Natural tragedies will occur for however long this planet exists. But we're horrified because while we're here, the furniture has been rearranged, and our daily routine has been altered so that now, we have to rebuild our lives. We have to establish a new and perhaps different "floor plan". But because human suffering has emerged, as it always does, maybe that floor plan will involve caring for our neighbor in ways that have lasting impact and are eternal. ... Maybe,... just like the earthquakes and tsunamis.

It only happened around the corner

Think of a fire in your neighborhood,.. around the corner. Or a car accident,... Maybe there's an explosion at the factory around the corner, that shatters a few of the windows in your house. Or, maybe there's an earthquake off the shores of Japan, followed by ocean waves that begin to ripple onto your shores in Los Angeles, California.....5,500 miles away,... merely around the corner.

The circumference of our planet is 25,000 miles, large enough to maintain some distance between neighborhoods, small enough to feel the ripples of whatever happens everywhere.

Reminders that we are a global neighborhood come in all forms. This week alone, in a Pennsylvania Amish community, 7 children died in a house fire, leaving devastated parents, a diminished community and a saddened world. A few miles outside of Philadelphia, a teenager took the life of his twin brother and their parents, leaving a shaken and bewildered community and a diminished and saddened world. Affects us all. The ripple effects enter our worlds, wash onto our shores and diminishes and saddens all of us. Let's remember in prayer and hold dear in our hearts those who are "flushed" away by waters of Tsunami's or those who are taken from us in house fires or home murders. If you measure a light year as 6 trillion miles, with the star closest to our sun being 4.5 light years away, on this planet, whether 10 miles, 5,500 miles or 25,000 miles, they're all merely around the corner or maybe even next door. Let's keep our world in prayer.

Taking it to the Streets

From the website Rethink Church, this post authored by Ben Rhodes, caught my attention. Its interesting and refreshing that this Church is in fact looking at how another perspective can be offered to those who might not otherwise enter a church. Our times are difficult and whatever your faith system is, we can probably agree that fear grips us at every turn. Taking hope to the streets as an antidote for fear, an avenue on which to live during our enormous feeling of uncertainty, is actually the method Jesus used to bring those of His time closer to God. ... He took it "to the streets". So what would the world look like if more of us looked beyond our Church walls. Read on:

With handmade signs that read “Got Ashes?” members of Urban Village United Methodist Church took to the streets of Chicago on March 9 to commemorate Ash Wednesday, the first day of Lent. They offered to mark a cross of ashes on the forehead of anyone who asked to receive it.

The Rev. Trey Hall, pastor of Urban Village, joined three- and four-person teams at six sites across Chicago. He says the gist of the teams’ invitation was simple: “Everybody’s welcome – Catholic, Protestant, gay, straight, everyone.”

Locations included rail stations, busy intersections and Daley Plaza. Banners at the sites read “Urban Village Church: Doing Church Differently.”

The 1-year-old church has members from a variety of faith backgrounds, including some who are new to the Christian faith. The church explains on its website that the cross of ashes is “a reminder that we are finite, that each of us has only a short stretch of time on this good earth, and that we should therefore live it well.”

In all, nearly 300 people received ashes – including two people who were waiting in their car for a stoplight to change.

Hall says that many of the people likely had at least a basic understanding of Ash Wednesday. Others were not as familiar, but were intrigued by what they saw.

“We answered people’s real questions: ‘What is Lent?’ ‘Why are you doing this?’ ‘What is this about?’” Hall said. “If we can reach people who wouldn’t be in church anyway (on Ash Wednesday), then it gives us a chance to talk.”

Hall finds an example in John Wesley, who founded the Methodist movement. Wesley is known for conducting much of his ministry outside of churches.

“Wesley was successful in connecting (people outside the church) to the larger, more mature Christian story.”

Even some longtime United Methodists were able to be a part of Urban Village’s Ash Wednesday observance. Chris Crook, a member of St. Andrew United Methodist Church in Plano, Texas, was visiting Chicago on Ash Wednesday.

“I was worried that I could not attend an Ash Wednesday service this year,” Crook said. He received his ashes on Michigan Avenue – and then he shared the details with his Facebook friends.

Hall and his church members are pleased to have offered individuals a connection to God that they might not have felt otherwise. He added, "Perhaps, by God’s grace, a tiny seed was planted."

The Senior Partner

I saw this today and just couldn't resist....

Traveling Light

When Jesus sent his seventy-two disciples out to minister, he told them to travel light -- no walking stick, no travel bag. There was to be no suitcase for carrying a change of clothes or for stashing away a sandwich. And all of this at a time when there were no laundromats or fast food places! What symbolism. Jesus asked the disciples not to rely on themselves. Their task was a difficult one, but it was to be accomplished by God's power, not theirs. Could all of this have a personal meaning for us?

People are challenged whenever they offer love and hope to those who sometimes might seem unlovable and hopeless. Those who care for others have to travel light, for they have to rely primarily on God's power rather than their own. And the result of their efforts will finally have to be God's concern rather than theirs. In that sense, traveling light would mean a total trust in God as we offer our care to those who need it.

Traveling light doesn't come easily for me, Lord. I'm tempted to trust too much in my own methods and to be too attached to the outcomes of what I do. We work in partnership, Lord, but help me to see that you are the senior partner.

Its a slippery slope,.... Be careful out there

Let's take a break from Kenya. Let's talk about Philadelphia.

I think this is a story about hope gone bad. A misguided, out-of-control, switched-track sort of hope, of which we are all capable. Its a slippery slope. But I've hesitated writing this because I have frequently held that horrific events speak for themselves and many times we can engage in rhetoric without resolution? However, important issues were raised in a column recently published in the Philadelphia Inquirer concerning the case of Dr. Kermit Gosnell, a local obstetrician who one worked against the mistreatment of people of color in the medical system. Outrage and disgust are two of the obvious terms that come to mind and so I'll dispense with them now so as to not trivialize the matter further. More descriptive words do not occur to me at this writing.

But there is power in language, nonetheless, and if through words, we can begin to consider creative resolutions or at the very least, how to avoid the path toward evil (the ultimate objective?), then let's see how we can begin the discussion,... meaningfully.

The story of Dr. Kermit Gosnell is one of profound sorrow. The alleged events that at least 8 infants were brutally murdered through savage abortion techniques, and that at least one mother was killed are indeed beyond human understanding; a tragedy for both victims and alleged perpetrators and far beyond sensible explanation. The specific issue of how the health care system and those responsible for safe guarding health health of the disenfranchised has been recognized and given voice over the years. Yet the larger injustice, of course, is that the conditions giving growth to this situation have persisted for decades and still the "victims" themselves of the non-functional systems remain voiceless. Unfortunately, unless political, economic and other societal staples are reconditioned, we''ll continue to be confronted by such health disparities and people will continue to die. Sadly, all said before without much change. But we know it doesn't have to be.

The story, for me, takes a personal detour here and in a different and profound way, begs a larger question: How did the life of a promising young physician turn sour? What happened?

In the early 1970's I was a student that the Philadelphia College of Pharmacy and Science (now the University of the Sciences), in Southwest Philadelphia. A gentleman by the name of Herman Wrice, founder of the Young Great Society (YGS), came to speak to my class about volunteering in the surrounding neighborhoods, Mantua, Powelton Village, etc, for educating those in the neighborhoods about the value of appropriate health care, working at clinics, etc. For those of you unfamiliar with the civil rights landscape of Philadelphia in the late 1960's and early 1970's, the Young Great Society was created to combat some of the very neighborhood-damaging ills that are present in today's social environment: drugs, gang and personal violence, poverty, poor education, ..you get the picture. Herman Wrice was its founder and one of the leading neighborhood activists of that era. Accompanying him was a young physician by the name of Kermit Gosnell. Now, when told about the upcoming visit by Mr. Wrice and Dr. Gosnell, I expected a white, idealistic physician who would talk about the desperate needs of the neighborhoods without much follow-up. In those days, young black physicians or black role models of any profession who would come before a pharmacy school composed of mostly caucasian students were hard to come by. We were mostly trying to find our own way, not for neglect of others, but simply because we were oriented in the mold that after you find your way, then go back to your neighborhood and make a difference. That was the tract I thought I wanted to pursue. So when Dr. Gosnell walked into the room ..tall, lanky, proud,..clad in bell-bottomed pants, an open collar "superfly" shirt and an afro,..a sway of arrogance and defiance?,... sure, ..but personally, I was impressed that this was someone who had indeed come back to his neighborhood to make a difference in improving the quality of health care for his neighbors. He in fact proceeded to talk passionately about how we can achieve balance in health care in underserved neighborhoods. He asked for volunteers in this effort and I and my best friend, both African American (2 of 6 in a class of 150), gladly did so, and were the only ones.

As it turns out, not much came of that effort, but still, he had credibility with me because he was "hanging out" with Herman Wrice, one of the premier community organizers of our time, and because he gave an impassioned talk that realistically depicted the health care situation in the neighborhoods at the time. Students of the era at many institutions were inspired by the few who tried to embed some semblance of hope and encouragement in us when we were caught between not knowing how we could contribute to the upward mobility of society, and being bombarded by television images of police forces hosing and killing students on college campuses, if we dared to try. We think of Martin Luther King, ... but there were others,.. Leon Sullivan, David Richardson, Herman Wrice. Many of us went on to obtain graduate degrees and embark on a successful careers, while trying to meaningfully contribute to helping achieve equity in our society. Indeed, much of what has been accomplished over the ensuing decades has been because of those who tried to lead us by example, activism and sacrifice, and who (sometimes unwittingly) left lasting impressions while doing so. Among them, Dr. Kermit Gosnell. He and others showed that someone could, in fact, show care and hope in dealing with very real society issues, at the same time that a successful professional career was being pursued.

So, Dr. Gosnell's story leads me to ask : What happened? Can this derailment of hope and encouragement occur for any us? It can indeed, and so the even larger issue is: how do we remain hopeful and continually remain a source of inspiration for our young people in all professions? Its still rare to find professionals who are willing to share time,... we're all very busy and are distracted by other "more important" needs... being present takes time, ...showing up, takes time from other things. Leading someone through the discouragements of life takes time.

Perhaps we can learn from Dr. Gosnell's story that we are all vulnerable, despite an initial life attitude that seems admirable, but can, overtime, erode and become misguided. The full story isn't yet known, but we do know, or at least suspect, that Dr. Gosnell once held the hope that he could help his neighbors improve the quality of their lives. It is sad that someone whose gifts that are so desperately needed, did not continue to share those gifts for the betterment of the community he professed to love.

In this, we all need to be careful.... It is indeed,...a "slippery slope".

The good and and bad news,,.. or skylines

Los Angeles,... Chicago,.... perhaps New York. Could be anyone of these cities. But this, ladies and gentlemen is beautiful, downtown Nairobi Kenya. Makes you wonder doesn't it. How such a modern skyline in the capitol city of Kenya can exist adjacent to some of the most desperate poverty we know. And the progress of this city doesn't stop with its high rise office buildings and hotels.. Everyone is excited about the construction of modern "super highways". Literally, the boasting and expectation of relieving some of the worst traffic nightmares in the world is heard from many corners,... from drivers who are truly skilled at maneuvering tight spaces without traffic accidents, to pedestrians who narrowly escape death by crossing through these tight spaces, especially on the round-abouts. It has to be seen to be believed. But this is modern Nairobi. Its still building. The new highways are actively under construction with a target completion date of sometime in 2012. The excitement here is palpable. The scenes are far from the poverty ladened pictures that routinely are seen in media outlet.

Much has changed since our first visit, some 17 years ago. In those days, cell phones were far in the future, in fact, communication more often took place through unstable and unreliable phone connections and then more often than not infrequently. Now through fiber optic lines its inexpensive and reliable. The skyline certainly wasn't what it is today. The attitude of Kenya's citizens was largely one of despair. Changes over the years have brought vitality to this metropolis and with continuous renewal of hope, fostered in large part, I'm told, by it current leadership. There are mis-steps by the government to be sure, at the parliamentary level mostly. But the excitement of Nairobi is truly a good sign of a properous present and future. Congratulations are certainly in order.

That's the good news.

Meanwhile, back at the ranch, as they used to say (showing my age maybe?:-), even within this capitol city of Nairobi, within Kibera or Mathare Valley for example, each with at least 1 million desperate inhabitants, starvation, lack of cleanwater, illness and despair remain the order of the day. That's the bad news. But it can be even worse in the "upcountry" or places where the concept of a downtown Nairobi or Los Angeles, or New York is as unreal as traveling to another galaxy. Dreams of Nairobi are hard to find when their dreaming instead of feeding their children or having access to basic health care or clean water without traveling for one day to the nearest "borehole". This is a different skyline. That's,.... the very bad,... and sad news.

There's an obvious disconnect. Recognized by all, many stating grand plans to eliminate it, but the task to bridge the gap is huge.

Consider health care. There is a 6.3% prevalence of HIV/AIDS in Kenya, a nation of 40 million citizens. Of those with known HIV, the highest estimate of those receiving treatment is approximately 400,000. The most commonly heard figure is 200,000. So approximately 20% of those needing treatment are actually receiving treatment, at best. The enormity of this problem is probably felt strongest in the rural areas,.. not in city center Nairobi. And we don't even know what's happening at the cross borders at the juncture with neighboring countries, where mobility between countries combined with an enormous sex trade, provides the ingredients for explosive HIV prevalence. What to do? How can the gap be filled?,.. if only in this one example.

We all have the power to heal... if not physically, then emotionally, spiritually and socially. The gap can be filled through simply caring about and fixing the systems that produce the gaps in the first place. But Jesus made it even simpler than that. He healed through touching people. People were healed through touching him... and sometimes, by touching only his clothing (...If I can only touch the hem of His garment,.. remember that one?). Healing happens when we enter and touch each others' lives, or maybe even by coming a little closer than we are accustomed. Maybe someone needs only to touch our clothing to be healed. Gaps can be bridged, ... health can be restored and healing can take place.

The disconnect we feel is real. Fixing or lobbying for fixing systems that explode this disconnect either in Nairobi or in Philadelphia can heal and fill the gap, ..... bridge the disconnect,.... help us to touch people's lives. Maybe this will allow all of us to scrape the sky,... sort of like the skyline of beautiful downtown Nairobi.....Maybe.

Simon: "I want to serve"

Simon is a Pharmaceutical Technologist in Kilifi Kenya. Kilifi is in the Coast Province of Kenya, just on the Indian Ocean. Overall, it’s an apparently quiet place,.. nothing like the capitol city of Nairobi.. The traffic jams are non-existent, but people go about their daily lives just the same, albeit in a less frenzied pace. Simon is the chief pharmacist at the Kilifi District Hospital,.. the hospital responsible for the health matters of almost 5000 square miles (about 12,500 sq Km) of kilifi district.. So his job is to facilitate delivery of medications to hospital inpatients as well as those in close proximity to the hospital.

Its not an easy job. Dealing with the medication needs of the hospital is one thing. Dealing with the needs of the surrounding community is yet another. You see, the way it works is that, although the hospital takes care of some of the community medication needs, the majority of these needs are managed by dispensaries and health centers “closer” to those. Closer, is in fact, a relative term. There’s a phrase in Kenya used often when talking about distances, especially on the coast. That phrase is: "just here". When asked “are we there yet”,.. the usual response is” its just here”, which could me we have another 10 Km to go,.. but its “just here” in Kenyan terms. So the community health centers of Matsongoni, Ganze and Msumarini, are “just here”.

On this particular day, we’re driving between health centers and dispensaries, on not so smooth “off” roads to places where the villages and homesteads are disbursed some distances from each other. We’re driving and the time seems endless. Can’t imagine how it feels when you’re walking. And that’s what they do…. Walk. To “just here”.

Some of the places have only nurses and maybe a clinical officer, but certainly no physician and no pharmacist. Simon explains that there is an acute shortage of pharmacists and physicians in the medical system of Kenya, especially in the rural areas. When asked why, he further explains that the pay is low and the circumstances are cruel and demanding, the hours, grueling. Many health professional go the private sector, where pay is much more than when working for the governmental health system, as Simon does. So I asked Simon,… Why do you do it? His response: I want to serve.

Simon is a rarity, even here. If you had to go to work every day to provide a service to those who might night be able to pay, whom you might contract a respiratory disease from, where you might hear babies crying in anguish all day…. Would you do it? Many here won’t,.. But many will. And the truth is that most of us serve, in one way or another. But because Simon serves here, one more child will live. Because he is planted here, a mother will receive medication so that she can look for work, or, work on her farm, or, sell goods in the market place…..because Simon serves,… and inspires others to serve. In this, there is hope.

But that can happen anywhere, it can certainly happen in the U.S. where the needs are as great as they are in Kenya or anywhere, ...the difference is that we have systems that, arguably, could work and should work on our behalf. But similar to Kenya though or anywhere else for that matter, if systems don’t work on behalf of the poor, the rest of us are called to serve,.. like Simon, and with intention,.. not the intention of being recognized for service, but with the intention of lifting someone up. With the intention of being an instrument of justice, not charity. With the intention of “leveling the playing field”, which may not happen immediately, but over time, it happens. Simon knows this, and so he serves.

So, in our lives and travels to “just here”. What intentional service will we render today? We're all thinking about this, but going beyond thinking and into action is yet another matter. As we go beyond action in our own lives, one more child will live.

So Simon "toils" on, ...with joy, sometimes frustration, yes,.. but always with intention. Can we join him?

They're coming from everywhere

They came from everywhere,… as far as 20 Km from their village or homestead to this place called Ganze Health Center. It was small, had services like laboratory evaluations pharmacy distribution, HIV/AIDS counseling, but it was literally “in the middle of nowhere”. But it rendered service. Service to many who had no alternative, because they were sick or dying, because they knew no remedy,.. not even the herbal medications extracted from the field worked any more. The pain just wouldn’t go away. Or, maybe the skin infection from which their small child suffered was more than the young Mother could bear to see.

They came from everywhere, to this place with no Doctor, no Pharmacist and sometime no medicines, at least not the ones they needed. Frequently, they were told that the medicine wasn’t there. That they needed to go to the “local” chemist. But there they knew that the cost would be high, the distance sometimes far. Yet the clinical officers and nurses offered the care they could, providing the medicines they had, despite frequent “stock-outs” rendered by delivery shortages from government distributors.

Imagine your medical center that you traveled 20 Km to reach. Imagine not having an automobile or even public transit to reach it. Worse yet, imagine not having the money to travel by public transport, if it was available. Imagine no water, little food and insufficient strength to travel the long journeys, by foot, to receive some semblance of health care. Yet they come, because there is no alternative, because death stands close by, watching to intervene, if they don't come.

Global healthcare is in crisis. Obvious?... perhaps.. but we sometimes do not recognize and why people are so sick, nor why they remain so sick. Environmental reasons are surely present. There are places experiencing drought. Climate warming has taken a heavy toll. In places where mosquitoes and other insects prevail, malaria, denque fever and river blindness are similar in their prevalence as the common cold is in our world. The planet is large, and so there are still places yet unreached by roads and other symbols of infrastructure. Cities, towns and villages remain separated by huge distances. Although this separation has been mitigated somewhat by communication amenities such as cell phones and the internet, the east does indeed remain far from the West.

The larger tragedy is perhaps we haven’t considered what we can do about all of this. But its hard to even think about how we can take care of our neighbor, especially when the neighbor is on the other side of the globe. But what about our neighbor around the corner or next door. Its hard work. Given all that we must contend with to take care of our own lives, and now we’re asked to care of someone else’s life. I don’t think so. Its easier to just look away. Maybe when I look back, it won’t be there, or maybe it’ll take care of itself. Isn’t God watching out for this? Doesn’t He care?

Suffering is everywhere. They do come from everywhere,.. next door, around the corner, around the world, …and it doesn’t go away, if we pretend its not there, or if we simply look away or close our eyes.

A thought. Maybe God is watching, but watching to see what we’re going to do about the suffering, the pain our neighbor is experiencing. Maybe God is watching to see if we’re going to build a clinic 10 Km or 5Km closer to the village so that our neighbor doesn’t have to walk 20Km. Maybe God is watching to see if we’ll drill a well to a level where we can access water in areas where clean water, or just water is needed, or creatively devise other methods of water access on a planet where, despite drought, 75% of the surface is water. Maybe through creative research we can develop vaccines that will combat malaria or HIV. Or maybe we can enact a truly comprehensive health care law that will insure everyone. Maybe God is watching out,.. to see what how His creation will take care of each other.

Cain’s response to God,” Am I my brother’s Keeper?” has not been diluted across the ages. We’re still asking “Am I my brother’s keeper. And we’re still trying to avoid the obvious answer.

Not 25 anymore

Well, I'm not 25 anymore,.. or even 30 or 40. I've crossed over.. Crossed over to what you say? To the senior class,.... elderly if you will, those who are close to collecting medicare,.. or maybe we should already be collecting it.

I came by this startling revelation, when there I was, trekking through Kibera with my student team who are 25. Of course, I went through the paces, the hills, the rough terrain, the valleys, and the the hills again, as if I do this every day. The pretense was, I must admit, impressive, but so was the shortness of breath. Of course, I didn't dare let them see it,.. carrying on a conversation while at the same time drawing huge gulps of air. My alternating timing was perfect. No one knew, I think, that with each syllable was an equal and silent gasp. But in the end, I made it. Not 25 anymore.

So if you're inclined to hangout with those who are 1/2 your age (or maybe more?), fess-up, admit the disparity, or,.. if you don't, and you happen to keep up, the alternating breaths will do wonders for your sense of rhythm. But it may be easier to take up the bass guitar.

From peace at St. Mary's Guest House to using outrage as an expression of love

We’re staying at St. Mary’s Missions Hospital Guest house. Both hospital and guest house are within a gated compound on the outskirts of Nairobi (Langata). It’s quite secure with a bustling shopping area of small establishments just beyond the gate. By the way, the U.S. has no monopoly on three hair salons in one block. The local CVS and Rite could best be described as a small chemist shop in one block and Duka la Dawa (drug store) in another. Its not clear who owns these drug emporiums, by the way. Regulations are that only pharmacists or pharmaceutical technologists can operate such businesses,.. but when asked specifically about this, there’s lots of throat clearing and uncertain answers,.. so who knows. Let’s just say, I might be inclined to purchase my Advil somewhere else J. There are “real” pharmacies in Nairobi. Kibera, probably the largest slum on the continent, is within walking distance, and getting there, literally, can be done within 5 minutes (but the hills are steep, and if you’re over 30, you’re body doesn’t lie). The people are as congenial as you would want them to be with greetings of Jambo (hello) or Habari yako (How are you?) exchanged commonly, and it is quite uncommon to find anyone, particularly at the shops, who doesn’t end a conversation with asante (thank you) or karibu (you’re welcome). These are gentle surroundings.

Its educational as well. This past week, the guest house was host to a medical missions team, two physicians and 6 medical students, from Korea. This group was on its way to Tenwik Hospital, another missions hospital in Kenya. Frequently, travelers pass through here for volunteer work, study, or other activity that requires a temporary stay in Kenya. Next week another group is visiting from Korea. Last year, I shared this space with a group from Australia who operates a school in Kibera, and a missions pilot who regularly brings supplies from Russia. The stories the staff could recount, as well as those of us who are blessed with their hospitality, are numerous. There are those who return to St. Mary’s Guest House repeatedly as well as those who live here year round. Its easy to see why.

I have learned and am still learning that there is no greater gift to another human being than giving compassion. Moses and Leah, the staff at St. Mary’s, are hospitable, gracious and kind, providing a quiet, warm and required respite for those who extend compassion to others or who are in need of compassion themselves.

Children are abundant on the grounds of St. Mary’s. This is because the compound is also home to an educational center which contains a school for orphans. Even under these circumstances, children have the most delightful way of affecting our lives. Saturday morning, we were awakened by singing. Yes, literally awakened by singing, unintentional, yet deliberate. You see, the Educational Center is located within 25 feet of the guest house and the children were celebrating mass at 6:30 in the morning. There is no more beautiful sound than children singing in Kiswahili. And to be awakened by that sound on a Saturday morning, in Nairobi Kenya, is a statement from God, that at that moment, in that space, all is right with the world and that there is indeed hope. I remain convinced, that this is one of the many ways God extends compassion to us.

But compassion doesn’t stop there. We are called to multiply that compassion to, and in, others …, and if we are to link that compassion with hope, we must multiply compassion, especially to our children. But the multitude of children at St. Mary’s is only a microcosm of the children in Kenya, or in Africa in general. We can also see children in St. Mary’s Hospital. We see them at Carolina Clinic in Kibera,... and then, of course, there's Good Samaritan orphanage in Mathare Valley, another large slum in Nairobi. These children are heard too, and although surprisingly, these children sing, there are also tears.

A recent quote I’ve read states:

"Let us be the ones who say we do not accept that a child dies every three seconds simply because he does not have the drugs you and I have. Let us be the ones to say we are not satisfied that your place of birth determines your right to life. Let us be outraged, let us be loud, let us be bold." —Brad Pitt.

I could be wrong, but I think Jesus would have been outraged. His quote was: “I have loved you with an everlasting love.” I think he meant that, and I think that he meant for us to love each other with an everlasting love. Never to allow our neighbors to suffer for want of a clean glass of water,.. or even a hug. In overturning the tables in the Temple, Jesus showed outrage and anger at the prevailing culture. In our time, given our circumstances,..perhaps our call, simply, is to overturn our tables.