where is the hope

 

A few days ago, I messaged one of my nurse friends. “I think I can be creative with Mary’s bandages until the next crate arrives… as long as no one else gets burned.” Today, a little girl whose pants caught on fire showed up at my door. It’s when your ‘just enough’ turns out to be too little that hope comes hard. 

 

My friends who thought they just had to get through the summer are feeling this too. ‘Just enough sanity’ to survive till school starts has been hijacked by school not reopening, and I see a familiar hopeless look in your eyes. 

 

As I lifted the little girl into my tub, giving her Tylenol and cookies to distract her from what was about to happen, I sized up the damage. Thirty percent of the upper thigh, not over any joints. “The clinic sent you home to care for it yourself, didn’t they?” I asked, judging by the gooped on toothpaste and ashes that are considered “traditional medicine” for burns. 

 

Back home my friends are cleaning up different messes. The protest fires of injustice and racism and hate are blazing in Portland and elsewhere and the “traditional medicine” of white supremacy doesn’t debride without tears either.

 

Where is the hope?

 

The little girl started crying as I slowly rubbed away the crust that was clinging angry to the tender flesh. Not recognizing either the girl or her mom by face, I asked where they live. M’wanguni, the mom said, in between telling her daughter to not cry so loud. “That’s two villages over,” I observed, “How did you know to come here?” “I heard from the man whose finger you fixed that you were kind to people like us,” she explained. Ah yes. The man who presented me with a severed finger that the clinic wouldn’t touch except to cover with a square of gauze tied on with a condom. 

 

It’s never ending, the wounding is. For me or you. Breonna Taylor’s murderer still walks free; the poor are being pushed farther out of affordable housing; and demon sperm lady is practically surgeon general.

 

Where is the hope? 

 

There was a time when scenes like this would have wrecked me. More times than I can count, I’ve left a bleeding person alone in my bathroom so I could go outside and sob heavy. And while I’m holding tight to wound supplies and not BLM signs, I feel your pain too – I do. That I can’t march with you, that I can’t help teach your kids’ pod, that I can’t hand you Tylenol and cookies while we tackle this life together – it grieves me in its own way. 

 

Where is the hope?

 

I want to be optimistic; that the Tylenol will take the edge off, that tomorrow the pink skin will magically be brown, that medical neglect will no longer send people to my door. I want to be optimistic for you too; that the Covid curve will angle down and that black communities will be lifted up and that music will return to your streets. 

 

I love the optimists in my life, and I aspire to be one of them. Deeply connected to heart’s desires, goal oriented and stubbornly positive. Optimism motivates us to take risk and study burns and speak truth to power. Optimism serves us well… until it doesn’t. When the next patient is more critical than the last and the next tweet more heinous than the first it’s a sucker punch to the gut and all those Pollyanna thoughts feel childish. Confrontation with reality has sent more than a few optimists into rehab where we’ve tried to make sense of how we could have been so naïve. 

 

Where is the hope?

 

Wiser, more experienced, we get our act together. I order hundreds, not dozens of bandages at a time and silver sulfa now by the gallon. You round up screen shots for facebook ammo and amplify black voices as we try and figure out how to realistically achieve this thing we call healing.

 

But our expectations are tempered more than we admit. Where we no longer pray for miraculous healing and justice is only preached to the choir. Those brave desires have been swapped out for a safer, more cynical version… but at least we’re being realistic, and that feels grounding… though depressing in its own way. 

 

Where is the hope? 

 

Not knowing how to show up for myself, or you, or anyone, I show up to therapy and try to figure out where I am. I learn that the place I find myself is squarely in-between. I learn that God gave us two hands for a reason, so that we might remain deeply connected to our optimistic dreams while also deeply connected to the world’s brokenness. In the space between, wanting so much, and seeing so little, we feel the tension in every cell of our bodies, which opens the possibility of discovering that this is where hope is. 

 

When healed patients feel loved through hours of connection, I find meaning in the pain. Now  I’m hopeful, instead of devastated, by each new story that reaches my door. As I’m watching America from afar, seeing the end of conservative evangelicalism and the emergence of fresh faith, I feel hope for you in so many ways too. Hope lives in the already and the not yet – where we believe that change is possible while still sensing how broken we are. Where the light shines bright and yet darkness still permeates. Where heaven has come and yet is not fully here. This is where hope is.

 

Lament puts words to the insanity of it all. With space for both the longing and doubt that makes us human: That what we experience is awful, but not beyond redemption. That I’m powerless to fix it but I’m empowered by the one who can. That the-God-who-sees is made of everything I am not. That evil is pervasive but there’s more grace than I know. Lament roots us in hope by declaring that suffering is real, but mercy is near, and if everything we long for falls apart, the shattered dreams will, in faith, become the building blocks of a surprising tomorrow. This is where hope is.   

 

And by sowing tears and reaping joy we carry on, hoping against hope that we won’t be disappointed. As I optimistically wrap wounds and realistically still dispense the analgesics. As you optimistically cast your ballots and realistically pray in closets. We can go to task and then go to sleep because the results are not ours to manufacture. It’s in the space between optimism and reality that hope thrives because that’s where God is, involved in what is, working out what will be, and actively transforming everything in the process. And for this reason, and this reason alone, it will be ok. 

 

Hold on to hope, my friends. Let’s hold on to hope. 

  

closed for inventory: the gift of coronavirus

Our one grocery store in the province does this curious thing where every so often it closes for inventory. In the middle of the day. During peak shopping hours. 

In times past when we’ve made a special trip to town, all excited for meat and cheese, and have been greeted by the rejection sign on ShopRight’s door, I’ve observed that it’s impossible in that moment to NOT become “exclusively American” and question why the store doesn’t do this at night and why is there no concern for the inconvenience to customers and who on earth approved this from a profit and loss standpoint? 

Alas. There are no answers. 

Drama aside, the sign telling us to come buy cheese another day is a minor annoyance… but it’s a major reminder. 

Here in Zambia, we finally joined our friends around the globe in “shut down mode.” Your jobs, schools, stores, and gatherings have been closed down for a while now, and as of this weekend, ours are too. I keep thinking about the sign on ShopRight’s door: Closed for Inventory, and I find myself transitioning into a familiar practice. 

You see, this Covid-19 crisis isn’t our first rodeo. Going through the files of my memory, I believe this will be our fourth lockdown experience in 13 years. None of the previous threats were, in retrospect, as deadly as Coronavirus, but their features of marshal law, shortage of food and quarantine resonates with what’s happening globally at this time. And while Corona promises to register much higher on the death scale, our other Zambian experiences have, I think, matched Corona’s psychological impact in terms of not knowing how bad things would get or how long the crisis would last. 

Our lock-down experiences have fallen under the categories of political violence, public health crises and good old-fashioned cultural upheaval (aka, witchcraft,) each ranging in duration from three weeks to three months. During these times, the severity of the threat has ranged from mild concern, to actually lying awake at night waiting for someone to come and kill us. 

What I’ve learned over the course of many shut-downs is that these life-interrupting, life-altering events that make us curse and cry and question why elected officials can’t get their act together, are actually prime opportunities to do a special kind of turning inward. “Closed for Inventory” reminds us that when life as we know it closes down, this is our call to take stock of absolutely everything.

When Cholera demanded our work be suspended, I noticed how unnerved I was and started reflecting over my job: What do I love about my work? Why am I anxious right now doing nothing? Who do I really work for? What about my work makes me tired? Where do I feel energized? When things resume, what do I want to be different? I TOOK STOCK. 

When we ended up spending ALL THE HOURS OF ALL THE DAYS together as a family, and that made me feel stir-crazy, it presented more questions: What are our goals as a family? When our kids are old, what do we want them to remember about this time? Do my kids know how much I love them? How would they know that they are important to me? When things resume, what do we want to be different? WE TOOK STOCK. 

When our emergency evacuation insurers told us we were too remote and they couldn’t get us out, even if we were in danger, I felt vulnerable in a totally new way. As I noticed the cortisol flooding my system over the idea of being stranded without a safety net, I began to ask questions: Are we being smart? Which ranks higher: my desire to serve or my desire to be safe?  If I get really sick, am I actually afraid of dying? I wrestled with what my responses exposed in my worldview concerning life, death and purpose and pondered the false security that things like insurance tend to provide. I came to a place of acceptance regarding my own sense of control as well as my mortality. I got real meta, in a way that mattered. I TOOK STOCK. 

When “stuff” was hard to get (INCLUDING TOILET PAPER, YA’LL – WE SEE YOU) and I noticed my heart racing when certain items disappeared from shelves, we evaluated our commitments to minimalism and radical contentment. In times of greatest resource-insecurity, we made conscious decisions to downsize. Yes, downsize. We simplified our meal plans and wardrobes and reduced clutter in every space in the house. This sounds counter-intuitive when most people globally are currently hoarding, but we found it incredibly liberating. When stuff was not available in shops, we asked the question, Can we manage if certain items never return? Is this a need, want or addiction? Would changing our expectations actually serve our minimalist goals? When our grocery store burned to the ground (next one being roughly 400 miles away) we said, well then, this will be different. And we pivoted. The loss of material security does not mean the end of life, it means the end of life as we know it. In times of crisis, life is different, but not over and paying attention to what we want/crave/miss when its gone is informative. WE TOOK STOCK. 

I need to confess; this healthy introspection didn’t happen instinctively the first time around. When chaos erupted and big men with big guns started patrolling and everything was canceled, oh we freaked out – like normal people. The default reaction in human beings when faced with danger and insecurity is that our limbic-brain engages and we go into fight or flight response. “Panic mode” is the factory setting, despite not being very productive. I think for Jeremy and me, we were able to shift from panic to productivity simply because, even though we were wrapped up in our first crisis, it wasn’t the first crisis for the people around us. Instead of panic and worry, our neighbors immediately launched into story mode, and it was fascinating. They told us about Independence in ‘64 and whatever outbreak in ‘80 something and the riots in the early 2000's. They told us about how they learned to greet each other by tapping feet and bumping elbows. They told us about changes in local economy and food and what they did and how they felt about it then and now. They narrated from the past what we were seeing in the present and then declared like bosses, Twalikwanisha. We managed. 

Something about their crisis management plan made us both curious and jealous. Their obvious mastery over that default, limbic, panic-setting was winsome and compelling, and it was probably the thing that made me ask the first of all the introspective questions. Through their measured response, I was confronted with a significant contrast: People are throwing rocks and stuff is literally on fire and I’m terrified of anyone who breathes on me and it’s not like the people around me aren’t living with this chaos too… but I’m watching them gracefully change course… and it’s speaking to me that I’ve got some work to do. 

And I did. And as a family, we did. The key to thorough inventory is to pay attention to the felt emotions in your body and observe them with curiosity. When you feel anxiety, fear, anger, panic – any form of disturbance whatsoever – there is a question begging to be asked. And when a question is asked and answered, new awareness and therefore new emotions may arise that need to be observed and engaged, and that process needs to be repeated until you come to a place of ultimate inquiry: Is the way I’m coping with my situation actually serving me, and if not, what is in my power to change?

Now, as Corona presents yet another forced opportunity to stop and notice what’s bubbling to the surface and make a conscious decision about how to respond, I’m oddly grateful. Just because I’ve done this a few times doesn’t mean I’ve reached some sort of crisis-management nirvana. There’s a lot I’m not worried about because, been there, done that. But I’ve still got my stuff, obviously, and Covid-19 is presenting new circumstances and begging new questions.

I’ll just be transparent and share that I'm leaning in, and it’s already uncomfortable. Unlike previous crises which were isolated to Zambia, the fact that America is struggling at the same time means our funding has taken a significant hit and I’ve been feeling the growing pit in my stomach and a racing mind keeping me awake at 2am. As much as I’d rather mindlessly scroll Instagram right now, I now need to stay present to those feelings and ask, If funds continue to drop, where is the fear in that coming from? What does it mean to “have your needs met?” If you have to pick and choose, what populations or programs matter most? Can Fimpulu live with a Choshen scale-back? Who are you trusting for your provision? I NEED TO TAKE STOCK. 

From lived experience, I know that this is important… and the only way to do crisis well. At least I know that if I press into the discomfort, the fruit of introspection will last long after the crisis is over. This is the gift of Coronavirus.

The sign has been hung. This is our time. All of us. To do our work and take stock. Don’t waste it. 

love languages in missions

Hickory Dickory Dock

The Zambian mouse ran up the clock.

The clock struck one

The mouse started running down... but then he stopped to talk to his neighbor for a while and three hours later he reached the bottom without feeling at all late…

Hickory Dickory Dock.

There, I fixed it.

One element of Zambian life that I’ve imperfectly chosen to embrace is that of time. Zam-time is enough to make even the super-relaxed white girl crazy. I mean really. I knew white people were uptight about time but I didn’t realize how clock-centered I am until Zambia beat every last bit of sensible time-orientation out of me. For years I showed up to church at 9:00 because every week, they announced that church would start at 9:00, and every week, I sat there by myself for over an hour until the church secretary (who the week before had said the words, “come at 9:00”) rolled in at 10:30 and asked me why I was there so early. I learned that my pace of “casual stroll” was basically a dead sprint as the people walking with me started wheezing while we walked together. And after a few dozen scheduling debacles, I accepted that when someone said they’d stop by for a minute, that the rest of my afternoon was shot as we would indeed be enjoying that minute for a few hours.

White privilege means that my clock-orientaiton is honored in most parts of the world but in rural Zambia I simply unclench my fists and accept a more fluid concept, which is, in many ways, a true gift. 

This gift of time has come into focus for me in the past several months as I feel like I have less of it now than ever before while also finding myself busied with some of the most time-consuming activities possible.

I don’t know exactly how it started, but for quite some time, I’ve basically been running a burn and wound clinic out of my house. We’ve long known that the clinic doesn’t really do burns or wound care. They will tend to you once, swabbing you down with bleach and wrapping you with gauze but Lord help you if that wound needs more than a day to heal because “once and done” is all you’re getting at the rural health center.

Some time back, a patient came to me with a massive wound that was getting no better and after begging for help, I agreed to care for it. This particular woman’s story found its way into village twitter and it became known that I possessed ointments and bandages and skills that actually prevented scaring and gave people their bodies back. The clinic knows this and lets me be, accepting that they can’t complain about my lack of official licensure when they aren’t willing to take over for me. And the patients keep coming. Recently, it has felt like as soon as one person gets better, someone else is wounded and we’re just blowing through sterile gauze and antiseptic ointment and literally hours of my day – every day – are now gone.

honest emotions as I wished for everyone to stop getting hurt

With a school to run, funds to raise, my own children to tend to... I still feel guilty saying that I don’t have hours to spend on this task; I hate that: that by virtue of my clock-centered complaining I somehow make light of what some of these people are enduring. By and large, these are not minor boo boos that need a band aid and a prayer. The majority of people who end up at my front door are there because they need intensive care and the government medical system has utterly failed them. If they were in a first-world country, many would be in burn units and ICUs. My house is, for at least some of them, a last stop before amputation.

its not pretty underneath

I have had to excuse myself from tending to a patient so that I can go and sob on Jeremy’s shoulder over the injustice and the medical malpractice that makes our front room better than the hospital. This should not be, and yet, sometimes it is. The time that this particular outreach takes up feels like it should be of no consideration to me, and yet, with everything else on my plate, it is.

The pain and the injustice and the guilt take their toll and so it meant something that at a particularly low point, a mom of a boy I had treated came back to me to say, J has been asking about you. He told me, “Mommy, Bethany really loves me.” This is the boy that screamed bloody murder every day for six weeks while the burns on his arm healed at a snails pace. He can now hold a pencil, and the grace in his words healed something in me.

this boy - he has spent more than his fair share of sick time with me, but the smile is how I know he's better.

Later, the mother of a child that scowled at me and pushed my hands away as I wiped weeks of dirt out of the filleted skin on his foot came back and said, “Every time we walk past your house, C looks up and smiles and when I ask him why he’s smiling he just says, that lady who loves me lives there.” And as if two rounds of Hallmark quality lovey comments weren’t enough, God gave me the gift of a third and then a fourth who said that word LOVE and I wondered if there wasn’t something to this.

The adults are less cheesy, but I’ve seen a similar affect. When the bandage changes are done and they want to sit and talk a while. When our kids start calling them grandma and missing them when they aren’t there. Every visit hurts, physically, but there’s a deeper healing at work too and all present can sense it.

daily snuggles with grandma, before and after dressing changes are good for both of them.

Despite the fact that I continue to pray through every bandaging and treatment session, “Lord, heal them quickly – for their sake and mine” the un-asked for bi-product of the daily care and the daily concern is that it communicates love in ways that a once-and-done couldn’t have.

to make you feel extra cared for, the babies will put bandaids on your perfectly healthy skin too. 

I’ve spent the last 12 years trying my best to love people. That’s our mission statement in a nutshell. And if I really assess our work properly, our best programs and projects are the ones that afford us the opportunity to spend concerted amounts of time with people. When an area of our work puts us in front of the same people day after day, there is a love language being spoken and clearly heard.

Twenty six years ago, Gary Chapman taught us all that there are different love languages and that if you really want someone to feel loved, you have to speak their language. After the six hundredth super-long chat around someone’s fire or even just standing in the bush path, Jeremy and I started joking that it felt like all Zambians possessed the love language “quality time.” And after logging hundreds more hours spending time with people in the burn and wound arena, I’d say that yeah, it probably is. There is nothing efficient about loving someone through the time it takes for a third degree burn over ten percent of the body to heal, but in terms of communicating love, the relational investment trumps my productivity every single day.

waiting for pain meds to kick in with the distraction of America's Got Talent
(we've watched all of the Zambian gospel YouTube videos already.)

The western world historically has “loved” poorer, third world nations with money. It’s fast, its easy, and above all, super efficient. Even amongst overseas workers, there still exists a mentality of “present the gospel, move on” or in development-worker speak, “dump and run.” We make up for in material gifts what we aren’t willing to give in time. And suddenly, the mission field sounds really noisy.

First Corinthains 13 says that if you don’t have love, you are a noisy gong or a clanging cymbal. I think that if we, the west, take an honest look at our programmatic efforts, even those that try to be gospel centric, we’d have to admit that the love language of the recipient has not been considered.

If spending quality time with people is the greatest act of love in this context, then I wonder if 1 Corinthians 13 could stand an update:

If I speak an African tribal language, but am too busy to love with my time, I am a clanging cymbal.

If I plant churches and build schools at all over but am too busy to love with my time, I am nothing.

If I sacrifice my American comforts and move my family to the bush but am too busy to love with my time, then I gain nothing.

Love is patient with those who want to be with us; 

love does not boast of how busy she is;

it is not arrogant or rude in needing to do “more important” things;

it does not insist on getting back to work;

it is not irritable when things take too long or resentful of lost hours;

it does not make light of the hospitals shortcomings, but rejoices in best-practices; 

love bears tears and the blood;

believes that God is good;

hopes that healing will come;

endures the pain when it all takes time.

Love never ends. As for development, it’ll fall apart; as for workshops, they will cease; as for sermons they will pass away. … So now faith, hope and love abide, but the great of these is love through time.

I still struggle with feeling inadequate – not accomplishing what I need to and feeling like I’m coming up short in every area. And I still hate that so much of my time is going to medical care that isn’t my field of expertise nor really – in the grand scheme of things – my responsibility. But for every person, to step into that space, and allow me to place hands on tender spots for weeks on end in order to see them heal and enjoy their body again  – the process that takes so much care and so much time – if that is what it means to love, then bless it.

when the data doesn't know your name

It’s overcast today, which seems quite representative of how everyone around here is feeling. Yesterday, a little boy died who shouldn’t have.

He was extremely ill and needed more intensive care, and the staff at the clinic knew it. They told his mom that the child should go to the hospital right away. They handed her a referral note and when mom asked how soon the ambulance would arrive they simply said: the ambulance only comes for maternity cases.

It’s a phrase I hear regularly these days as this is the new policy. One of the most reckless public health initiatives I’ve encountered in my 12 years, I don’t know who specifically wrote the new ambulance rule, but it’s maddening. Patients (who are not pregnant) needing the hospital (25km away) are expected to stand on the side of the road and pray someone picks them up, which is doable if you are sniffling or in need of a mere consultation, but absolutely insane if you are unconscious or actively dying. Family members trying to save their loved ones often rush to our home where they speak the words, “maternity only,” leaving us to decide whether to pick up the government’s shirked responsibility – or not.

Not that it changes anything, but at least we know where the policy came from - just follow the money. The vast majority of funding in the health sector right now is targeted at MCH – maternal & child health. Zambia’s statistics are more than embarrassing when it comes to birth outcomes for both mothers and newborns and the influx of money is specifically meant to change that. So long as numbers stay happy and programs are deemed successful, the money keeps flowing which creates huge incentive for health departments to push systems that please the funding source – at whatever cost.

In Zambia, MCH is the priority of today which means that if you are neither pregnant nor post-partum, you are quite literally not the priority. This narrow emphasis has meant that emergency medical services – such as ambulances – have been reserved primarily for maternity cases in an attempt to save all the women in labor… at the expense of everyone not in labor.

The father of the sick boy rushed to our house and begged for help. I explained that while we would normally take him, Jeremy was in Lusaka with the vehicle and that he needed to push the issue with the nursing staff and remind them that an emergency is an emergency – maternity or not. He shrugged his shoulders in a way that resonates with how I usually feel when talking to government workers: preemptive defeat. He turned and slowly walked back – not rushing, since there was no where to rush off to. I shrugged also, mirroring his sadness and simply murmuring in his general direction, this sucks.

Four, short hours later, the sounds of mourning grew audible and the little boy died while an ambulance somewhere sat waiting for a “priority” case to call.

Wavering between acceptance and rage, I called Jeremy and talked/screamed/wept into the phone. We invest so much into community health, give me one reason why we should keep doing so while the people who can save the lives won’t!  The steady voice on the other end reminded me that the clinic staff are just following orders from someone above them – probably from someone who doesn’t care either, but is also following orders – orders from someone who is probably not in this country and whose paperwork keeps them detached from localized pain.

Fighting for women’s health might include reserving life-saving resources for mothers in need but truthfully I don’t think the woman burying her child today feels any bit of solidarity in this fact.

The ambulance policy is just one piece of a much larger MCH package by which women and children are being victimized for the sake of better outcomes on paper. Along with the promise of an always-available ambulance, our village received a “mothers shelter” which is a waiting house for women who live far and need a place close to the clinic to stay while awaiting childbirth. The concept makes great sense. On paper. But after the NGO seconded the building to local staff, the warm and welcoming maternity “shelter” soon became a concrete and controlling maternity “jail.” All women – even those who literally live across from the clinic ­– are required to move into the shelter a minimum of a month before delivery. If a mom goes into labor without having slept in that shelter, she is issued a fine. If the fine is not paid, the child’s immunizations are withheld until she pays.

Awesome. (insert face palm) 

Women loathe the shelter because they are consistently under-fed and constantly worried about the children they have left unattended at home. Many resort to using herbs and traditional “medicines” to induce labor – the only hope of jail break.

Apparently the only way we can improve delivery outcomes is to hold mothers hostage. After all, according to clinic staff, “You know how these women are.” Actually yes, yes I do, I know quite a lot of them, and they would love a safe and competent delivery in a place where they are treated with dignity and respect. And what’s happening here is not that. I was once asked by a regional MoH official why I chose to birth my children in America instead of at our local clinic and I couldn’t find any words for him other than, “are you serious?” The disconnect is unreal.

I have two friends who delivered babies in the last month. One mom, six weeks after moving into the mothers shelter delivered a baby that only lived a few hours. Mom had torn significantly during labor but the attending nurse, wanting either to protect herself or to avoid recording the infant’s death, decided to handle the stitching on site. For three weeks, mom was refused discharge while “waiting for her swelling to go down.” Finally the family demanded referral. Transporting her home from the hospital, I asked what the OB-Gyn had said. Sitting on her left hip and staring blankly out the window she answered, “he asked who the hell did this to me.” I gripped the steering wheel a little tighter, stewing on how I’m sure my friend must be so glad to have spent two months in maternity prison only to walk away empty handed and unable to sit.

I ran into another mom-friend crying outside the shelter. Her eldest, a three year old, had fallen into a fire and been terribly burnt. With mom gone at the mothers shelter and without a consistent person to watch him, the boy had been neglected and seriously injured. I encouraged her to go home and take care of her son, reminding her that she could come back if she went into labor. Wiping tears from her eyes she explained that she couldn’t leave because she wouldn’t be able to pay the fine. Realizing she wasn’t going to take my anarchist advice and just walk out, I told her I’d look after her boy’s burn care. With every dressing change, listening to him scream for his mommy, I felt both their pain. A few weeks later, mom went into labor and this baby too did not live. She went home to her burnt child, and wept bitterly for days.

Every funeral feels like emotional deja vu and I yell into the phone at Jeremy who is missing all this while enjoying ice cream in the capital, Is this what “saving mothers” looks like? Systemic violence and denial of agency, and still, the children die? I don’t believe for a moment that the public health experts want this. I’ve seen their shiny white pick-ups arrive for data collection, occasionally accompanied by a researcher from the US, looking very “fresh-out-of-Michigan-in-the-winter-white.” Brilliant minds have rallied around the challenge that is improving maternal & child health and their skilled research is meant to drive productive change. The data says “do this,” so the money creates systems to “do this” and the people on the ground are told they’d better “do this” – but I’ve attended three baby funerals in the last month and something here seems remiss.

And maybe, today, the people who call the shots and cut the checks are staring down at papers and not people, and they are looking at numbers and not names, and they will produce P scores that say this is all ok because, “on average,” the initiatives are working. But 184 villagers will gather around another little coffin tonight, and a mother will bring her burnt child to me for a fresh bandage, and a young woman will wince as she gingerly sits on a wooden stool, and none of them have the luxury of knowing where their stories fall on the scatter-graph. 

I don’t believe that the researchers who are driven by faceless data and impersonal  indicators are evil or that they hate women, but I don’t think they hear the stories that matter either. “Data,” as compared to living, breathing humans are two different sources of information and the unspoken confession of the NGO world is that data is just less messy to handle.

Sometimes, I’m frustrated by our search for funding to make our work go farther and deeper only to hear, “you’re too small.” Really? And by too small you mean too intentional? Too compassionate? Too relational? I get your math and what you mean by “efficient,” but my moral compass won’t lead me down that path. The individuals matter. The Big Numbers will win the Big Grants, but neither will feel the weight of grief resting on this village today. A small body will be lowered into the ground and the data capturers of Big Aid will take no responsibility because they didn’t even know his name.

Raphael.

His name was Raphael.