Tuesday, May 17, 2016

Medical Ministry

My vision has been to provide healthcare in partnership with local churches so that together we can meet physical and spiritual needs in this remote corner of Uganda. Jesus said,"What does it profit a man to gain the whole world and forfeit his soul?" I have always thought the same thing about medicine. What have I done for my patient if I have cured his physical disease, yet have done nothing to care for his spirit? As a busy doctor with limited time and abilities, I feel that the most effective way I can do this is by partnering with local churches and pastors, who have the special gift and calling of caring for the spirit.

When I launched my medical ministry, I started by asking to meet with church leaders in our area so that I could explain my desire of providing healthcare in partnership with them. Here's a pic of our first meeting.
 From there, we began making plans on how we could best work together to serve our community. So far, I have travelled to 8 villages to provide medical care, often visiting over multiple days so that I can see the majority of the patients who present. I have been thankful for our Toyota SuperCustom van, a diesel, 4-wheel drive, beast of a car that has gotten me everywhere (well, almost!) that I have needed to go. I pack up medications, medical supplies, a portable ultrasound machine, and our healthcare team and we set off down potholed, dirt and mud roads with low hanging trees that often scrape on the roof rack of the van to reach remote villages. After spending 3 years working primarily in an office and hospital, it has been really exciting to set off in this mobile medical vehicle taking in the landscape of Uganda, bumping down small roads and footpaths, often with amazing views of the mountains to bring healthcare to people who need it the most. Here are some snapshots from one of my recent adventures...
 Thomas and Bihwa, two close friends who have been working as translator and church facilitator, respectively. Thomas is also my language helper and is fluent in 5 languages. I'm struggling to learn just one of those! Keep praying for me!
To date, this was the only village we could not reach by car. We had a big rain the night before and the road was very slick with mud. The van kept sliding and we had a hard time staying on the road. We decided it was safer to park and continue on foot. We briefly stopped here to ask for directions to make sure we were still heading the right way.
It was probably for the best that we left the car because the road soon turned into a foot path that went through a cocoa shamba.
After an hour of walking, we finally reached this church with a room full of patients waiting for us.

In each village we visit, we set up clinic in a church, roadside building, or home. Here are a few snapshots of "clinic" spaces we have used.
We usually draw a crowd of onlookers who stand at the doors and windows to see what is going on inside.
I have been so thankful for the portable ultrasound machine I brought from the U.S. (in the bag I am carrying), thanks to generous donations from our supporters and a grant from SonoSite. I cannot explain how helpful this has been while caring for patients in a place with limited diagnostic equipment. I have done many prenatal ultrasounds, abdominal ultrasounds, and echocardiograms for patients who would otherwise not have access to these services. Thank you to everyone who helped us to purchase this machine!!

One of our more interesting clinic days was in Bubukwanga, about a 25 minute drive from our home. Pictured above on the right is Holly, our team nurse. We worked at a small health center adjacent to a camp for internally displaced persons (IDP camp). This camp is home to 8,000 - 10,000 people who had to flee their villages during recent tribal conflict. The health center was overwhelmed by the number of patients who needed care and was severely depleted of medications. They also lost several staff members who fled out of fear of retribution from people in the camp because they were from conflicting tribes. Thomas' (above middle) mother was living in the camp at the time. More on that story in a later blog.

I hope to post a blog soon about some of our interesting cases. Stay tuned!

Safari!

For Eli's 7th birthday, we travelled to Queen Elizabeth National Park. Located in southwestern Uganda, this beautiful reserve stretches 764 square miles and is home to an array of African wildlife. We had a wonderful time relaxing at a safari lodge, driving into the park in search of animals, and taking a boat tour on Kazinga Channel, which connects Lake George and Lake Edward. Below are some snapshots from our trip.

View from Kingfisher Lodge with Mount Stanley (the 3rd highest peak in Africa) in the background.

The kids were excited to have great views from our van while on safari. Our guide didn't know how to drive, so Marc had the adventure of navigating through the mud and potholes in search of wildlife.
We saw lots of amazing animals. Here's a Water Buck grazing near Kazinga Channel.
Water Buffalo. We saw many of these in large herds.
Ugandan Cob - so graceful and beautiful.
Roadblock! We saw lots of these very close to the road. I guess you don't have to be afraid when you are bigger than most vehicles.
The kids enjoyed having a closer look at the animals from our roof rack.
Marabou stork. Queen Elizabeth is home to over 500 species of birds.
Monitor Lizard
Baboon mother and baby enjoying a banana.
Katelyn directing us to the animals.
Our favorite part of the trip was a boat ride where we got an up close look at some of the more dangerous wildlife.
Crocodile
Ahhh! Isaac and Katelyn made us so nervous as they ran all around the boat and insisted on getting as close to the edge as possible. We certainly didn't want to have to jump in after them if they fell in! Check out that hungry hippo submerged in the water.
Hippo family
Enjoying one of the many beautiful sunsets over the park.
The kids loved the pool, even though the water was frigid!
Had to stop for a pic as we crossed the equator.
It was a memorable birthday for Eli Marcus!

Tuesday, March 8, 2016

A New Car!

Hear the voice of Bob Barker from The Price is Right when you read that title. I never thought I would be so excited about purchasing a car that is 14 years old with 321,000 kilometers (199,000 miles). But I am! After three visits to Kampala to look at vehicles, and finding that the options were very limited, we finally came across a large van that met all the specifications we had in mind for our family car.

Thank you so much to each of our supporters who made this purchase possible. We are thrilled to have a reliable vehicle than can safely transport us back and forth from Kampala on our resupply trips. Now we can fit our family, groceries, and medical supplies and still have some breathing room after these weeklong trips. Thank you for your generous support towards this purchase!

Car shopping in Kampala was a surreal experience. Picture the shadiest used car lot you have ever been to, with the slickest used car salesman. That was pretty much our only option in Kampala. Each bonded warehouse (used car lot) was packed with vehicles bumper to bumper. There was almost no room in front of or behind the cars to even pass through. To really inspect a car, the salesman might have to move 10 or 15 cars out of the way to get to the one I was interested in. Most of the cars on the lots were fifteen to twenty years old, and many had odometer readings in the range of 40,000 - 60,000 miles. This was obviously suspect. Various people told me that most car lots wind the odometers back, so it is unwise to consider the mileage when making a purchase.

Another interesting quirk is that the vehicles on these lots are not registered in Uganda or given license plates until they sell. This is done so that the salesman can save money by not paying a registration fee for a car that might spend a long time sitting on the lot. Because the car is not registered and doesn't have plates, it cannot be taken off the lot for a test drive. So, I was left making a decision about a fifteen to twenty year old car without being able to look at it closely, with no idea how many miles it had, and without being able to go for a test drive! Quite a challenge, indeed.

Additionally, since almost no cars are manufactured in Africa, virtually everything is an import with an inflated price. To arrive at the sales price, the government takes the value of the car when it is imported, then adds 35% for an environmental tax, 25% for an import tax, 22.5% for sales tax, 6% for a withholding tax, and 1.5% for an infrastructure tax. The final price you pay is at least 190% of the value of the car, and maybe more if the seller has marked up the price!


A typical car lot in Kamapala. How do they get those cars in there?!?

To find a car, I went shopping on three separate trips to Kampala. By my final count, I had looked at sixty cars on fifteen different lots. I learned a lot in the process and was thankful for the experience, but in the end I was worn out. I did come away with information on how to do business in Uganda, how to negotiate for prices, and how to navigate around the capital. In the end, those lessons were probably worth it.

After spending five months in a borrowed Toyota LandCruiser (thank you Rhett and Holly!), we decided that our family needed a bigger vehicle. We settled on a Toyota Super Custom - a rugged eight seater van with lots of space in the trunk. These cars are plentiful in Uganda and are often used as commuter vehicles. It's big brother, the Toyota Hiace, is used as a shared taxi called a Matatu. It looks very similar to the Super Custom, but has additional seats so it can hold as many as twelve passengers. After settling on a Super Custom as our desired vehicle, I went on a search throughout Kampala for one that was in good condition. Sounds easy, right?

When I found a car that I liked, the first test was to see if it would start. Since all the cars here are imports, with most coming from Japan, they have been traveling for several months before finally arriving at the car lot. I found that almost all of the batteries were dead or had been removed for the overseas journey. The salesman would have to get someone to bring a new battery and then jump the car to get it to start. 
Yes, he is jumping this car without jumper cables by holding exposed wires with his bare hands!

Once I got a car to start, which did not always happen, I had to make a decision without a test drive. I checked all the gauges, windows, locks, mirrors, looked under the car, examined the engine, looked at the oil and radiator fluid, surveyed for water damage and rust, and revved the engine to look at the exhaust. Very few cars passed this inspection. When I made a short list of vehicles in our price range that looked to be in good shape, I called a local mechanic to come and thoroughly inspect the cars. The salesmen almost always tried to talk me out of this. They questioned my trust in them, they offered a small warranty if I would agree to not bring in a mechanic, and generally tried to dissuade me from taking this extra step. When I persisted and brought a mechanic in, he often found something concerning like a radiator leak, rusted chassis, damaged exhaust system, etc, that would knock the car off my list. Round and round we went. Sixty times.

Eventually, I became so frustrated that I decided to import a car directly from Japan to cut out the middle man. I found one that I liked and made plans to buy it through an importer. After telling me that I could purchase the car remotely at an auction in Japan and have the importer ship it over for me, at the last minute he changed his mind and said that he would buy the car at auction and sell it to me later. Deflated by this news, I had to wait to see what his price would be after he bought the car. After several days of waiting, I found out that he did not bid high enough at the auction and lost the vehicle.

So, back to the drawing board. I finally found another car that I had my heart set on. Good condition, good inspection, good price. Unfortunately, it sold to another buyer just after my mechanic finished looking at it.

Feeling deflated by these experiences, we had one last trip to Kampala to find a car before the one we borrowed had to be returned. I went from lot to lot for the third time and finally found a GREAT car that met all of our needs. It was a 2002, which was about six years newer than anything else I had seen. It had arrived in Kampala from Japan the day before, and the odometer was showing 321,000 kilometers. This was much higher than any other car I had seen. Since it was a new arrival, I think the dealer hadn't had time to wind the miles back yet, so I felt like I had a good idea of how much wear was on this car. Additionally, this particular salesman seemed to be more honest than any of the others I had met. He offered me a three month warranty on the engine and radiator by agreeing to repair any problems that came up for free.

The car looked to be in great shape and passed the inspection from my mechanic. But without a test drive, I was very nervous. However, with no other options I took the plunge and bought the car. When I got it to the car repair shop for a more thorough check, I was thrilled to find out that there were no major issues. The mechanic told me it had been very well maintained. He predicted it would last us for many years to come. 

Sealing the deal on our new car.
Our first upgrade was to add a full length roof rack that can hold up to 600 lbs! This has come in so handy for all the items we have been buying for our building project. Pictured above we are transporting 300 meters of hose pipe to bring water to our construction site.
We love how many people we can fit in this car. Here we are transporting eleven people for an outing to a traveling zoo. There are a few kids hiding in the back!

Thank you again for your prayers and support for our car buying adventure. We love traveling in this new (well, 14 year old) vehicle. We can load up all our groceries and supplies and still have room to move around. If you come to visit us in Uganda, we would love to take you for a spin!



Wednesday, March 2, 2016

Children's Ministry

Children's ministry is very close to our hearts. We have served as Sunday School teachers for ten years in the various cities we have lived in. We have found that Sundays in Nyahuka have been a bit challenging for us as we try to figure out how to get our four children to sit through a two and half hour service in Lubwisi. To make things more interesting, we often find that we are not just in charge of our four kids, but we are often looking after ten other kids who have been sent to church alone by their parents just to get them out of the house. We usually draw a crowd as they jostle to sit by our little ones so they can look at the books or crayons or cars that our kids have brought to the service.

The church we attend has not had a children's ministry for almost two years after losing some of their regular teachers. We often count about fifty children who are wandering in the worship hall and in the yard while the church service is happening. Someone is almost always crying, falling off a bench, hitting another child, or running around, which makes it difficult for the adults to concentrate.  We have been praying regularly for the church to launch a children's ministry again to help engage these little ones with the Word of God.

We thought about starting a ministry on our own, but we realized that a better long term solution would be to support and encourage a local church member who felt called to this task. Well, our prayers have been answered! The congregation recently sent Marc's language instructor (Thomas) to the capital for a training conference on children's ministry. Since returning, he has been faithful at gathering the children together in a building behind the church for singing and Bible stories during the sermon. The first Sunday that he did this, there were sixty-two children who came. He recently asked us if he could borrow our copy of 'The Jesus Storybook Bible' to use for curriculum.

Please pray for Thomas, and Bundamalinga Church, as they seek to share God's love with the children of Bundibugyo. And please pray for these little ones as they faithfully attend each week and now have the opportunity to hear God's word at their level. We look forward to finding ways that we can encourage and empower this ministry.