triaging grace

I have been thinking for the last few days now which can be a dangerous exercise for me.  Since having children, I no longer have the luxury of  undisturbed moments for reflection and contemplation.  Most days I live on the surface of thought life with ready interventions for child arguments, replies for the inevitable question, “mom, I’m hungry, what can I eat”, or with some sort of silly tune to pacify a 16 month old babe.  On occasional quiet evenings, when the children are sleeping “all snug in their beds” I might allow my thoughts to wonder down paths that were familiar only in decades past (it seems) when I could sit, listen to STING , Harry Connick, Miles Davis  or Enya, sip tea and contemplate  the writings of writers, poets and philosophers (which typically did not include Veggie Tales or Scarredy Squirrel) 

So today, when driving from Kijabe to Nairobi with three children in the backseat quite occupied by themselves and one baby on the lap fast asleep, I drifted into a thoughtful abyss reflecting on the last few days in Kijabe, themes of grace, mercy, compassion swirling about trying to find their rightful place as the dust settles in my mind.

overwhelming response for medicine at Longerin Village

overwhelming response for medicine at Longerin Village

 I find myself caught at times between the  tension between grace, mercy, compassion versus the concrete logic of defined terms such as: “stewardship”, sustainability, responsible use of resources and strategic development. The pendulum has shifted in Sub-Saharan Africa where in the past years there were relief and development efforts, now we have efforts that are outcome oriented: how many were saved, how many survived, how many were fed. Of course in efforts to curb corruption and for reasonable governance I can see why there was a shift, however, now it seems  only ‘sustainable measures’ are worthy for implementation. All other efforts are considered crippling, placating, demeaning or even damaging.So the question that seems to resurface for me again and again is how does how does one calculate what is a wise use of resources when it comes to treating the sick in Africa.  Have the creators of these ‘catch phrases’ ever visited a village with medicines and had to explain to the people how it is that their methods of wise resource allocation and sustainability actually works (and likely subtracts them from the equation of receiving help).And the very logic which began with kind origins almost seems a distorted kind of grace:  not everyone can be helped so help those who are likely to have a good outcome. This may be wisdom but what about grace?I just wonder about all these things.  I am caught in a ledger of thoughts which wants to come out balanced. I want to practice due diligence with how I use the time, energy and resources that I have,- but I have not yet found there to be an easy template of who to treat, what to charge, how to help, how to train, to teach, to give as well as receive from a community in need.

Today I thought of the ministry of Jesus.  Wouldn’t He seem to all accounts to have ‘missed the memo’ so to speak on good resource allocation? He treated the desperate cases, the psychopathology, those who were marginalized, who the community even cared not to care for. He treated those with illnesses that were chronic and permanent, the blind and the lame.  He treated the dead.

Could not the same argument be applied to Jesus? Why waste your time and limited resources (in speaking of his limited ministry on earth) on those who were already dying and wasting away…those who may not recover, those who no one will receive into their care, those who are big risks to save.  Why not spend resources on those who are marginally ill but are guaranteed to be a ‘treatment success’?  But Jesus treats those who seem completely untreatable.  Kingdom mathematics seem to have it’s own system of accounting,- it isn’t quite the ‘outcome based’ type of management that we aspire to implement,- or is it?  Perhaps we just differ on how or what we define as an ‘outcome’. Is ‘success’ a number or a thought, a soul, a life or a feeling?

And my thoughts turn to Baby Esther,– to anyone who would see her, she is a waste of resources.  Her massive hydrocephalic head, her eyes which protrude outside the little sockets, her paper thin skin barely covering her malnourished body. She is 3 kg of medical complexities and I am ashamed that I had thought of her on these terms. It is at times easy to quantify and qualify life here, where the line between death and life is very thin and crossed over often.  She is 3 kg of beautiful, precious life for which she fights for each and every day.  She has already endured in her short 6 months more pain than likely I will ever have to face.  Her small frame has overcome significant illness and unbelievable odds.  Born at 28 weeks in a dung and stick mynyatta with no medical help, while the traditional midwives were digging her grave, she clung to life.  She has refused to give up hope and that is why, beyond all unreasonable measures, in contrast to good resource allocation,  Jay and I have helped to seek out medical care for this little babe. I received an email today detailing how uncertain Esther’s outcomes may be.  In the next 8 weeks she needs to gain 3kg in order to be strong enough for shunt insertion. Almost seems impossible, completely untreatable, a case that perhaps Jesus would take.

7 month old baby Esther
Image 2

Last weekend I heard a sermon on compassion taken from Luke 10 and the story of the good Samaritan. “Who is my Neighbour?”  was one of the questions posed, and defined as, “Someone who has a need for which  I am aware of and in a position to help”  This for me and possibly for you, means baby Esther.  She is my neighbour and with this in mind and with her face in my memory I can do no less than help as best as I am able.


AIM AIR plane bringing baby Esther to Kijabe Hospital airstrip June 14th, 2013

I have not reached any concrete conclusions on how to go about treating the sick in Kurungu.  I am limited in resources and cannot possibly treat every one.  But the way I go about helping needs to be less cognitive and more compassionate. I need to leave outcomes in the hands of the God who is the creator and giver of life. I want to treat with grace, not triage grace.

For those who would desire to help or contribute towards the care of Baby Esther or for others of the “least of these” please feel free to email us: 

“For he will deliver the needy who cry out, the afflicted who have no one to help. He will take pity on the weak and the needy and save the needy from death.” Psalm 72:12-13

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