Tuesday, April 21

Whenever I come to Uganda, I find I can be useful just by making appearances in the right rooms with the right people. That means meetings. Some of these are not going to be directly relevant to what Jay and Mark have signed up for, but they are glad to come along for the ride. And I am glad to have their company. Pilgrim staff work hard, and almost all of their work involves partnerships: with USAID, the Ugandan government, the churches. I am sometimes useful in being able to say to some of our partners what even senior Pilgrim staff cannot say; coming in from the outside as President of an international board means I am given up front a certain allowance of social forgiveness.

The Pretty Side of Kampala

This comes in handy with our first meeting at the Ministry of Health. Dr. Meyers Lugemwa is the senior deputy for malaria control; Solomon has two questions he needs to get answered, which I need to ask. First, we have had a MoU (memorandum of understanding) in process for several months waiting to be signed by somebody in the Ministry of Health. Dr. Lugemwa is cordial, apologetic, notes that it must be stuck in the legal office and commits to get the thing finished. Second, the Ministry of Health is sitting on serious quantities of the chemical used in our spraying protocol, all of which will expire in November. We really need him to commit that to Katakwi; he is more shy about this ask. Apparently the stuff has already been committed to two other localities. (Elections are coming up in 2016 and this is a way for the MP’s to show they are doing something about public health in their districts.) The problem is that, if these chemicals are used without any other co-ordinated efforts (e.g. mass drug distributions, use of treated bednets, etc.) the end result will be exactly no medium- or long-term benefit to the people. We end with the good doctor committing to a conversation with “affected parties;” he is a good man not in an easy position, and I resolve to pray for him.

Our second meeting is with the USAID mission director at the US embassy. This is a courtesy call, and so will be brief, about half an hour. (It actually takes us longer to clear security). USAID directs PMI (the President’s Malaria Initiative), and they have trained, and continue to train, our field staff in IRS (Indoor Residual Spraying) and in other aspects of malaria control.
First, I just want to say Thank you, to the mission director Leslie Reed and the senior staff; which they appreciate. Solomon then gives an overview of Pilgrim’s process and goals in the Katakwi project, an intervention across three sub-counties that should come close to eliminating malaria for nearly 38,000 people. Leslie is a seasoned professional diplomat, gets it all instantly, asks a few pointed questions, which Solomon addresses comprehensively; we have some further conversation with her medical chief, Dr. Kassan, shake hands warmly all around, then leave. The tone and content of the meeting are all good news. Pilgrim has a grant proposal for $500k pending before the Global Fund for this project and it is a good thing to be getting good grades in the eyes of USAID.

In the afternoon, the team splits up. I meet with half a dozen national leaders of two Pentecost associations and a co-ordinator for the Church Malaria Program, an interdenominational effort to mobilize the churches in grass-roots support for the kind of thing we are trying to do in Katakwi. Mark and Jay go elsewhere. Here is Mark’s description:

We were advised that the mental health inpatient facility in Kabala, called Butabika, had a drug and alcohol detox unit! One of the areas of focus for our week here has been to identify, develop, and connect resources in Uganda for the treatment of alcoholism. In any setting, alcoholism is a complex problem, stemming from a number of economic, social, spiritual, medical and culture forces that have conspired to create a significant problem. In Uganda, there are very limited solutions for those entangled within it. So….if there was a hospital here that was working with treatment and detox, it would make great sense to visit and see what they were up to.

Dr. Ben Khingi, a Ugandan board member with Pilgrim, has an inspiring vision and commitment to his people. He advised us to just “show up”, confident that we would be able to make connections. He was spot on. We were warmly welcomed and had a great visit with the clinicians and staff there. The facility was impressive in general, it was expansive; located on a hill with a sweeping vista of Lake Victoria, it was neatly kept and staffed by warm, compassionate people. Although the medical director had gone for the day, we were able to have a great conversation with one of the drug and alcohol counselors, briefly meet some of the patients, and talk to several of the managers of the unit.In a very moving expression of God’s grace, several of the patient’s approached Fr. Jay as we left the hospital, asking him to pray for them.

“As with most complex problems, easy solutions over-simplify. Pray for the coming of Christ’s kingdom as Pilgrim and others seek to bring together the pieces need to address the issue of Alcohol and Drug addiction in this place.”

By the time we get back together, it is nearly 7 p.m. I feel like a wet rag, but I am energized by Jay and Mark’s reports of their excursion. I am not sure where the partnership meeting with the Pentecostals will go, even though we did wind up with one or two concrete action items, but I am learning that God will use just about any small effort to bring forth great fruit. May it be so, in this matter, with these dear brothers and sisters.

Monday, April 20

Morning comes early after a wonderful, but long, Sunday. We’re heading back to Kampala today, but before we leave we have two important pieces of business at the school: a student debate on alcohol abuse and the dedication of a new “hostel” or dormitory for the girls.

The Great Debate

The debate is first up. I have mentioned before that Ugandans are very ceremonious, and today is no exception. A great deal of care is taken bringing desks outside for the teams, setting them up carefully under the fig tree, and positioning a blackboard with the team rosters, the names of the timer and the judge, and the simple proposition: Alcohol should be abolished.

The teams, immaculately dressed in their best school uniforms (reserved for special occasions) take up their positions, with the entire school standing in rows around them, and a special seating area for “our visitors” as we are always called. In addition to me, Mark, and Jay, we include three American friends of our CEO in the US: Erin, Valerie and her daughter Molly. The judge announces the ground rules, the timer rings the bell, and they’re off!

The general atmosphere feels (not surprisingly) like a British courtroom. The kids clearly relish the formality and the chance to show off a higher level of English. The proposer addresses his argument to “Distinguished faculty, honored visitors, honorable judge, respected timekeeper, my fellow students, and the world at large.” Which pretty much covers it, I think. There are howls of appreciative laughter.

The case for abolition is fairly straightforward: alcohol weakens the body, kills the brain, destroys the family, undermines society, and is in all other ways vile, disgusting, and reprehensible. The proposers, however, seem to lack an enthusiasm for their subject and make the mistake of assuming the audience is on their side, as if the case were self-evident.

Jay and Mark Listen to the Debate

The opposition is of a different mettle. They are led by a fiery young woman about five feet tall, who goes on the attack right out of the starting gate. She is articulate, forceful, and superbly controlled; her English is flawless. She argues that to give the government power to abolish anything so commonly used, is an invitation to despotism. She points to the deep cultural roots of alcohol use in Teso, notes its benfits as a “socializing instrument” whereby “people who otherwise may not even like each other find their opinions changing, to the point that some of them even get married.” She disputes the dark view of the proposers, suggesting that alcohol in limited quantities has health benefits, that its use is a matter of individual choice, and the government in any case should keep its nose out of people’s business. It’s about the best libertarian argument I have heard on any subject.

The debate is interrupted by a point of order raised by the opposition: “Honorable judge, I wish to point out that a member of the other team has crossed her legs. I do not think this is a dignified position for one engaging in a debate!” A storm of laughter. Crossing one’s legs is indeed an offense against social etiquette in Uganda (though Westerners are almost always given a pass) and the offender is sternly corrected by the judge.The arguments proceed, and at the end, the guests are invited to say something.

Jay Drives Home His Point

Jay goes first. In a booming voice he tells them “I am an alcoholic!” People here are not used to the public admission that is basic to the method of AA, and this really gets everybody’s attention. After a brief and devastating description of the harm he has known, he calls everyone “not to even start” lest they “cause a brother or sister to stumble and fall.” Many nods, followed by a loud and respectful applause.

I weigh in with an acknowledgment of the problems caused by legal abolition (I talk a little about Prohibition in this country, which actually exacerbated alcohol abuse), but then speak of the responsibility of individual choice. The timekeeper rings the bell on me, so I just take it away from him (Hey: I’m the bishop!), which generates whoops and cheers from the audience. I ask them to be especially careful of the little 100cc “sachets” of hard liquor now available everywhere and wind up with a couple of examples of “stinking thinking” from our friends in the ajono group just down the road, concluding “if you don’t want your brain to work like that, don’t even start.” Dr. Guy gives a similar assessment to Jay’s, but focuses on the physiological effects– the slow degrading of the body caused by prolonged and excessive alcohol use, but also the spiritual effects of anger and hopelessness, teaching science and faith at the same time. All this takes less ten minutes. The judge, a biology teacher, prefaces his verdict with a biology lesson on alcohol in the body, and announces his decision: the audience must decide for themselves and must live with their decision! Solomonic, I think.

We move over to the new girls’ hostel, where Solomon announces that Valerie will fund the construction of a third dormitory next to the existing two. The girls erupt in a long traditional ululating cheer. This gift, about $4,000US gives huge added security to our young women. At present Pilgrim rents quarters outside the school fence, across the road. The buildings have security guards, and our matron, who is adored by the girls, keeps careful watch, but the risk is simply unacceptable. I think, three down and one to go. If we can build one more, we will have all of our most vulnerable kids within the perimeter.

The rest of the day is spent in the journey to Kampala. We make a couple of tourist stops: the ancient rock paintings at Nyero, the coffee co-operative warehouse and roasting plant at Mbale. Our speedy journey slows to a crawl on the outskirts of Kampala, but Solomon does the back-road thing again, and we get to the hotel by 11:30.

Tomorrow: you guessed it. Meetings.

Bishop George introduces me as “his brother bishop”; applause, big hug, then I’m in the pulpit. I preach on the Good Shepherd in John 10. How does the Church show forth Jesus as the Good Shepherd?

I tell a story.  When I go into the more remote villages, sometimes I will meet small children who have never seen a white person. They know the universal word for the pale variety of human beings– mzungu–  but they have never actually seen one. So they will run along the road next to me as I walk laughing and shouting mzungu, mzungu!  Sometimes I stop. I walk up to the smallest one, who suddenly gets very sober, and I put out my hand, inviting them to touch me. They usually freak out. “Mam! Mam! (No, No!)” they shout and back away. When I once asked a mom why her little girl did not want to touch me, she replied laughing, “She is afraid that if she touches you she will become white!”

People obviously like the story, totally get it, lots of laughter and broad smiles. I then move to Thomas the apostle, and the Resurrection appearance of Jesus who invites him to put his fingers in the Lord’s wounds and his hand in the Lord’s side. Thomas comes to faith in Christ in that invitation. He can see two things: first he sees that the Lord is not ashamed of His wounds, just as He is not ashamed of ours. He is not ashamed of our suffering or weakness, but literally holds them in His hands. But Thomas also sees the Lord’s glory, His power, His infinite love and eternal joy. He wants to be filled with those things, so He touches the Lord to become like Him.

So, the question is, can we show the world such a Lord, so they can touch Him through us? Can we not be judgmental of others’ sin, condemning them, or moralizing about them, but rather show them the Christ who bears their wounds in His hands? And can we by our joy and love show them His? I was brought to faith by such Christians, and I can see them here, but the abiding temptation of the Church is to act as though we were a place for “good people”, which is like saying a hospital should be full of those who are already well. I trust that, as we follow Him, the Lord will let us touch Him more deeply that we may become like Him, so that others may see Him revealed through our mercy and love, and also be able to touch Him by faith.

People seem encouraged. After communion, I head back to the house, eat briefly, then to the school Pilgrim runs in Soroti, Beacon of Hope College, where Jay and Mark and a few other visitors are already in worship with the community. This is the last Sunday of the term. 500 kids, many of them the poorest of the poor, are gathered with their faculty under the huge fig tree that serves as their church. The morning is rich. They dance, sing, praise God in so many ways. I preach again, a sermon of encouragement, of pride in them and their faith, their accomplishments, a message (I hope) of power for them as they go back to their villages for three weeks (many of them cry as they leave school- especially the girls who find here a dignity and respect that is not accorded to women many places in the countryside).

Our ajono group

After lunch, we visit Pilgrim’s health clinic with Dr. Guy who explores the possibility of setting up detox protocols here, then later in the afternoon we go down to Pamba market to visit our old friends in the ajono group– about thirty men and a few women are sitting around a common pot of local brew sipping from long straws. There is a serious card game going on. Jay and I are invited in to kibbitz (i.e. watch, don’t help). The game is a mystery, sort of like Uno, but not quite. We hang around and talk with a few of them. They are always amazed to see a bishop and a priest who want to visit with them, but now a doctor as well? What is going on?

The evening is spent in a wonderful dinner with staff. By the end of the day, I don’t remember if I ever had a problem with my phone. Where is my phone anyway?

Sunday the 19th

You know you are a Westerner when the main thing keeping you up at night is connectivity issues. Our Lord taught us to pray for our enemies, and last night my enemy was AT & T. All kinds of little tabs and options for cell coverage in my little iPhone– absolutely none of them works. Nothing. Zip. Nada. Dr. Mark has Verizon and faces the same problem, but bears it with a serene equanimity that is beyond me. And Jay? Jay is connected to everything.

Thanks to T-Mobile, Jay is getting e-mail from the moon. He got updates from his carrier in mid-air letting him know what country he was crossing into as he flew! He is surfing the web smoothly and efficiently, posting media to Facebook, graciously lending me his phone (they only charge him 20 cents a minute???) when I have to make a call. I have always loved and respected the considerable intellectual and spiritual gifts of my canon for formation: the way he connects recovery to a Biblical worldview, his affable good humor, his grasp of history and culture here. But I am now beginning to think he has a sixth sense about just getting through life. Jay’s flights were all on time. In a Kampala restaurant, Jay knows the absolutely best thing on the menu at the absolutely best price. From now on I am just going to do what he does: T-Mobile. Brussels Air. Fajitas (beef, not chicken– the chicken will kill you).

So, I have Jay on one hand, and on the other Dr. Mark Guy. Mark is obviously a first-rate physician, but he is also gentle, wise, able to communicate cross-culturally, and compassionate. Most important, he is a deeply formed Christian, and conveys scientific information in the context of God’s hope for His people and His Church, something that the Christian leaders here deeply appreciate. Yes, he has Africa experience from previous years in Sierra Leone, but the way he has been able to settle in among the clergy and people of Teso, gaining their confidence in such a short time, is really remarkable.

So I have a seer on one hand and a healer on the other. I am surrounded by a vibrant and hopeful Church. In Pittsburgh, I serve a wonderful Diocese with deep personal knowledge of the Cross, supported by excellent staff. I chair an NGO that is attracting international attention for our work in malaria, education, and food security, all carried out by some of the most talented and faithful people I have ever known.

And I am angry about my stupid phone. Exactly like Jonah angry over the vine that stops shading him.

I need to go to church this morning.

I am picked up at 6:45 a.m. to preach at the 7 am service at Saint Peter’s Cathedral. When I get there, the place is packed, about two thousand souls. I slip through the side entrance to the chancel and am greeted by old friends,while the youth choir sings traditional Ateso hymns. I think all Ugandans can sing, but the Iteso are sort of like the Welsh- they love choral singing with rich harmonies, and when you are in the middle of two thousand people doing that in the power of prayer, it lifts you into a different place. I get on my knees and pray that God will enlighten my heart with His Word, and fill my mind to preach faithfully. I am suddenly aware of the fact that everyone here has bigger concerns than their phones: they carry the burdens of poverty, sick children, unemployment, alcohol abuse in their families, disputes with relatives over marriages or land. There is no room for first-world dilemmas in this place.

What I need to preach has become pretty clear.

Saturday, April 18th

We resume the conference early in the morning with some prayer and singing. Yesterday, the focus was on information– alcoholism and its spiritual roots, pathology, treatment and recovery, and family dynamics.

Today we will see what our participants want to do about any of this.

Over many years in Africa I have learned that the most useless thing a Westerner can do is “help,” i.e. create a plan that makes us feel good but has no buy-in from the people who would be most affected. If there is to be a plan, it will have to come from them, and that is what today will be about.

Dr Guy Works with the Churches

We start by hearing from them what they got out of yesterday. For nearly an hour, a roomful of normally reserved Ugandans give articulate responses to all they heard. It is clear that they took in the information deeply and that several lights went on-  addiction as illness, the ways families are affected and can make the problem worse by codependency, the problem of Law, the difficulties of church attitudes. I am again impressed at how well-spoken people are; English is their second language, but their speech is clear, elegant, and sometimes very moving.

Presenting their work

We move into four areas of emphasis for further discussion that became apparent yesterday: the formation of AA, advocacy for children, changing the attitudes of the churches, and the need for further training. In each category I challenge the group to come up with all the questions they can think of, then narrow the field to the two most important: this takes the next hour. After a tea break, they divide into four working groups, each devoted to one of the areas of emphasis. Jay convenes a “model AA” group, complete with Big Book, and Mark works with the group focusing on changing attitudes of churches, while I pile in with the group on further training. The common task of all four is to come up with one concrete next step to advance the work, including a “by when” and “by whom.” They work on this up to lunch. Then they come together for the final push– presentation of their small group work, and revealing the concrete next steps.

This is the devil’s hour. Lunch has a universal effect on human beings- personally, I just feel like lying down for a good nap. But we point it out, sing a couple of rousing choruses, and just plow ahead.

The First AA Group in Teso!!

It is an exciting afternoon. By three o’clock, two people have stepped forward to form the first AA group in Northern Uganda! Jay gives them each a Big Book and we all applaud. Each of the other three groups appoint a leadership team and agree on the next steps. When we adjourn, they stay in the room to schedule, exchange email addresses, and then pass on the information to us. Mark, Jay and I agree to keep in touch to support their work and make plans for an eventual return for a further training  conference. Florence, the bishop’s wife, yesterday voiced to the whole group her strong feeling that this ought to be heard by every pastor in Teso.  While that may be a big ambition, given the lights I am seeing in people’s eyes, I wouldn’t be surprised to see something even greater.

Friday, April 17

Jay did indeed get in on time, and the Kampala team meets us at the airport.  We get in at 4 pm on Thursday, eat dinner, change cars, and head directly to Soroti.  First, we have to get out of the capital.

Driving in Kampala is a near-death experience, even under the best of conditions. At rush hour it reminds you of what someone once said about war: hours of boredom punctuated by moments of terror. You can sit in a traffic jam for what seems like days. Fortunately, Solomon knows the city like his own hand, and is possibly the most skilful driver I have ever met. He takes us off the main road through a tangle of alleys, dirt paths, and narrow streets. We go up and down hills, in and out of neighborhoods, and barely an hour later are clear of the congestion of this city of six million. His driving defies both law and physics, but I am happy for it.

The road to Soroti is much improved; most of the 362 kilometers are smooth going, slow in places because of the constant flow of trucks heading to the Sudan, but things only get a little rough on the last leg from Mbale. We arrive in Soroti at 1:30 in the morning, and are settled in by Pilgrim’s wonderful staff at the comfortable house of our founder, Calvin Echodu. We are up early, arriving at Saint Peter’s Cathedral to begin the conference we are leading: Alcohol Addiction and the Churches.

Some of our class

This is the second training. Jay Geisler and I introduced the subject last summer in the course of two brief seminars. This 2-day conference is in response to multiple requests for further help. We are enormously grateful for the third member of our team, Dr. Mark Guy, a family practitioner with Allegheny Health System who has extensive experience in addiction, medical treatment of severe alcoholism, detox protocols, and the like. A major goal of our involvement is to establish an AA-centered approach to recovery, based on the understanding that addiction is an illness, not a moral failing. Mark will be hugely important in this effort.

We are expecting 25 strategically chosen clergy, social workers, and elders. When we arrive at about 9:15 a.m. there are only three or four present. I feel my heart sink..

Of course, I am forgetting: this is Africa!

Jay gives the ABC’s of Addiction

Over the next half-hour the room fills, including the Bishop of Soroti, George Erwau, and his wife Florence, who will remain with us for the entire day. This is a measure of the significance of alcohol abuse in this region, and as we move through lively opening singing and prayers, into introductions of the participants, Bishop George disclose personal reasons for being there as well: family members he saw ruined by adiction while he was growing up. Many others have similar stories. It is clear this is not merely an abstract problem.

Dr. Guy at Work

We have structured the first day as an intense dose of information, a morning of bad news followed by an afternoon of Good News: I lead with a Biblical exploration of the spiritual roots of addiction in idolatry. Jay does the ABC’s of alcoholism– how it begins, what alcoholic behavior looks like, why it is best seen as an illness. Mark gives a thorough descrition of the physiology of addiction, the symptoms and progress of the disease, and exactly how it kills. Participants make extensive notes, ask pointed questions, pay careful attention. By mid-day, the atmosphere in the room is, um, sober.

Bishop makes a Point

After lunch, we move into the Good News: I talk about God’s curing the soul through gracious love, what the Church looks like when this becomes a reality. Jay opens up the twelve steps through the lens of the Beatitudes in Matthew 5.Mark focusses on successful treatment of withdrawal and the crucial role played by family and social supports..The afternoon ends with an animated question and answer session.

Returning home we find a feast:: Pilgrim staff greeting us and James  our wonderful cook having prepared a  magnificent spread of roast  goat  ((my personal favorite), pork and chicken..  We try to retire early..  Good luck  with that!

Thursday, April 16th

The fun began when Dr. Mark Guy and I arrived at Dulles International Airport early Tuesday morning to discover that our flight had been delayed nearly three hours. This meant we would be spending a day in Dubai, and leaving Thursday morning for Entebbe, Uganda. It occurred to me I had been praying all week for more time to finish work I brought with me and to prepare for the beginning of the addictions conference on Friday. I guess God heard me!

If you took the set from The Jetsons, pasted it into the Waterfront Mall, multiplied by 1,000, then dropped the whole thing into the middle of the desert, you’d have Dubai. Our flight attendant said it was a great place to go clubbing. (Isn’t this a Muslim country??) Mark and I both being middle-aged Christian nerds, we elected a more sedate option: lunch, followed by nap, some planning for the conference, dinner, conversation, prayer, and bed.

Woke up today feeling very rested (maybe this layover wasn’t a bad idea after all), made the plane in plenty of time. This, however, means we will be arriving in Kampala mid-afternoon, and leave immediately for Soroti, a rugged seven-hour drive. I am hoping Jay made it in from Brussels last night!