Friday, 15 January 2010

Last day at 8


Asha steps into the big world of being 9 years old tomorrow.

How the world has turned 3287 times since the day she was born I cannot imagine.

As she continues to blossom, we can only be amazed at God's goodness to us.

It seems like just yesterday - well in real time it was just yesterday - that I was flying across the cold winter night between Delhi and Patna - hoping to get to the hospital in time for Asha's birth.

Despite the heavy fog of those days - the plane landed at 12 PM and I was met by Elias Bara and the hospital jeep for the drive down to Jharkhand and the Nav Jivan Hospital.

Dr. Colin Binks had found decreased fetal movement for Asha on the 15th of Jan and had decided that a C-section was in order for her. And so I dashed across to try and make it home.

Elias drove through the night and we arrived safely just after 7 AM on the 16th morning. A bouquet of flowers for Sheba, thankful prayers all around, a pint of blood from me for the forthcoming ordeal, and then at 9.30 Sheba was wheeled into surgery.

I was there with her when at 10.10 AM Asha entered this world with the sweetest cry imaginable.

And today we are at her last day of 8.

Thursday, 14 January 2010

Palliation

Mr. Janak was admitted yesterday to the JSK centre for palliative care.

Our basic philosophy of palliation is that as much as possible a person should spend the last days of their lives at home. End-of-life care means many things. It means being in as much comfort as possible. Surrounded by family and friends. Having assurance of their passage from this life to the greater one that awaits. Being loved and cared for. Working through any unprocessed issues - appreciating and being appreciated.

The brutal grimness of many people's lives does not quite fit the above picture. But that doesn't mean that we haven't seen many of our HIV positive friends spend their last days in peace, even as they came up to - and then walked through death's door.

Mr. Janak situation is so extreme that we just had to admit him ourselves.

We met Mr. Janak and his wife 3 years ago. Both have HIV - and multiple other overlapping and confounding issues. The long and short of it is that she has suffered from a stroke - due to a brain infection - which has left her paralysed on one side. He has been in and out of alcohol - and was severely beaten up in his drunken brawls in the past. As his immunity has decreased Mr. Janak has fallen ever more frequently ill. Tuberculosis has been the main foe - and despite getting him onto treatment repeatedly - which has meant repeated advocacy on his behalf with local health authorities - he has also repeatedly defaulted on his drugs. All the hours our staff spent with him - encouraging, educating, just being - seem largely washed away by the bottle.

For the last few days things have spiralled totally out of control for Mr. Janak. He has been at home - semi-comatose and incontinent. He seems paralyzed from below the waist. His semi-paralyzed wife is unable to clean him and he has multiple bed-sores. The other family members have long since given up on care for him - leaving a scared and sad mother as his only hope.

We tried getting him into a hospice. No beds available. We took a deep breath and admitted him here.

Mr. Janak was sleeping this morning when I saw him. He was under a white sheet. What he was dreaming about I do not know. We prayed for him last night, and he was looked after all night by our nurse.

This may be Mr. Janak's last day on earth. At least he is in a clean place where people care for him.

There are many 'what ifs' in Mr. Janak's life. The time to act on those is past. Many things were tried - and for various reasons they did not turn out the way we hoped they would.

But now we have a work of care to do.

Tuesday, 12 January 2010

Good friends

One way to know who is a good friend: if they drop in unannounced - do you rustle up something to make sure they stay for dinner - even if you have already eaten yourself.

Drs. Santosh and Vanita Matthew and their amazing kids Grace, Mark and Nancy meet that test and surpass it by a mile.

photos courtesy Dr. S.P. Matthew
- here the Matthew clan cheerfully eats our kichidi and egg bhujia!

The good doctors run the Ashok Hospital in Dahisar - and are involved in many other amazing activities. One of them is that they are home-schooling their threesome - which is still something of a novelty here in Bharat-land.

Grace and Mark are holding their own pretty well - especially with the dedicated inputs that their parents put into them - and Nancy has recently blossomed into a lovely little girl - spunky, talkative, full of fun and caught up in the whirl of whatever is going on.

We have gotten to know the Matthews as a family at the church camps over the past couple of years - and know the senior M's from their involvement in the fledgling greater Mumbai chapter of the Evangelical Medical Fellowship of India.

Mathew is a fearless thinker and speaker of his mind. Always willing to learn. Always looking to see how he can serve God more. I have been deeply challenged by the way he is willing to be radical in his obedience to Jesus.

The sum of their lives can be seen in their family. What a joy to be with. Would that they were neighbours instead of living on the other side of the great urban sprawl that Mumbai is.

But then again we are deeply grateful for their stopping by - and heading off for home well after 11 PM on that fateful night last week.


Our prayer is that our next gen Matthews and Eichers will continue the pilgrimage together.

Its a great life!

Monday, 11 January 2010

Truth

While at university, a woman called Jody joined our Wednesday evening Bible-study-pot-luck. She quickly made friends with the circle, introducing herself as a missionary-kid from South Africa who had been to boarding school in Southern Germany and was studying criminal justice at a near-by college.

Over the next few months Jody became part of the church group, and told us that she was particularly interested in working with gang-related issues in New York city - and that she was often on the streets, working with gang members in negotiations, as well as working with prostitutes and street children.

After some time she also told me that she was HIV positive - and that it had happened during an emergency operation while she was in Africa - and that her parents had disowned her because of her status.

I had good friends who had gone to her boarding school in Germany and asked one of them about her. He did not seem to recognise her. When I asked Jody about my friend, she said she did not really know him.

In the middle of all of this, she applied to Yale Law School for her higher studies. Unsurprisingly, she did not make it in and was crushed. Various people counselled and encouraged her. But then came the good news. Somehow, she had been admitted over the summer. There had been a second list and she was in. Congratulations flowed.

Just before the term began, one of my flat mates - who was a professor in International Relations at Yale - wanted to contact Jody. He called up the Law School to get her number. No record of her. He followed up and contacted the professor in charge of admissions. No record. She was not admitted at all.

When confronted, she fled. Jody dropped out of our lives. It had all been a set of fabrications. I saw her once or twice in the distance after that - and she crossed the street and went in the other direction. Other church members had the same experience.

How much of what Jody said was true?

Behind every good fabrication are nuggets of truth. Jody clearly knew something about missionary kids - Black Forest Academy in Germany is hardly the most famous school in the world (word of pardon to any BFA grads out there...). Her statements about gang warfare and negotiation may have come from an interest in the area - and then more.

One semi-truth leads to another - and then another. A relentless cycle of wanting to be accepted, wanting to believe. I would imagine that Jody started believing much of what she spun out - and finally cracked when the falsehood was called. Where is she today? Where are the many whose lives are built on fabrications? Probably nestled into a new web of stories.

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The last week I have been meeting 'Bill' - the Canadian man who was picked up off the street in South Mumbai in a terrible condition. He has been recuperating in a local hospital, and finds it hard to remember things. Yesterday when I met him, he told me that we had gone to a restaurant the previous day. Bill has been lying emaciated in his hospital bed for the past 5 days - waiting for his papers to be processed for Canada.

Bill has told me about his being a dentist in a small town in western Canada. As we have talked over the last week, he told me about his estranged parents, about his fathers' dental practice, about the high life he used to live, about his search for meaning and the substance and alcohol abuse that he used to dull his pain. Bill talked about taking friends on his boat and the ways that he tried to be loved by preparing hand-made pizza for them, and the disappointment at their lack of true friendship when things became tough for him. Bill told me about the loneliness of being admitted for an overdose at the hospital and how his friends had cheated him of his money. He narrated how he lived for the thank-you notes from grateful patients and how his approach to dentistry had grated with his father's more straight-laced approach.

All these stories - and so many more - while looping back to certain themes. That he was going to make a change in his life. That he was feeling paranoid. That those who were looking after him may have been doing something without him knowing.

How much was true?

I did a google search of his name and town - and found that a business partner of his was sent to jail for bilking him of $70,000. His father's name as a prominent dentist also pops up on line.

The pain seems real. Many of the details are probably true too - though the sequence of events may not fully line up.

Jody is lost. Wherever she is today - if she still is that is.

Bill is lost too - but with all the confusion of his mind - there is still hope that he can rebuild his life. It won't be soon - seeing the damage that has been done to his body, mind and spirit. It isn't a guarantee - there are no little pills that can be popped to make everything all right. But real healing and real recovery is possible.

Bill doesn't really want to go back to Canada. "I don't want to 'face the music'" he repeatedly says. His rambling comments hint at a person who desperately wants to belong, to be appreciated, to be good.

Isn't that like each one of us? The more I meet Bill, the more I see him as an everyman - and see facets of myself in his story.

Bill has been running away from truth for a long time. He has - hopefully - hit rock bottom. But how he goes forward will depend on how much truth Bill is ready to take on board.

What Bill needs most of all is to follow someone who really counts - and to hold onto a truth that is more than running away from his problems. A truth that can look the muck of reality square in the eye - and yet have to gritty hope of redemption and transcendence.

Jesus said, "If you hold to my teaching, you are really my disciples. Then you will know the truth, and the truth will set you free." (John 8.31b-34)


Saturday, 9 January 2010

Cold

Would you like to see a picture of a country on ice? Take a look at the shot of Great Britain absolutely frozen which I just grabbed off the BBC website. Remarkable satellite shot (not one of those hoaxes) makes me so glad I am in Thane at this time - with the only ice around being the ice-cubes in the fridge.

These days are about as chilly as it gets here - and we did not sleep with the fan on last night - one out of perhaps half a dozen nights in the year.

Given the huge amount of attention weather gets across societies (every second cough is explained as due to 'weather change' etc.) it is remarkable that our well built world actually regulates itself so well.

Compared to the bleak cold of most of space - interspersed with the very occasional searing furies of fire - our little blue speck is a very hospitable place. Even if large parts of the northern hemisphere (including large parts of North India) are pretty cold right now.

Wednesday, 6 January 2010

Hungry

I sat next to the man and listened. He was emaciated, lying on a hospital bed. His eyes sunken but intense. He spoke urgently, telling me his story.

It was a jumble. But some things stood out. He had been robbed. He was confused and couldn't remember things clearly. He had met many people on his wanderings - some good - others who had taken advantage of him. Somewhere along the line Prakash and Vinod found him. Did he first meet Vinod in Goa? Was it here in Mumbai?

We will call the man Bill. Bill is from Canada. He almost died on the streets of Mumbai.

At the end of November we had organised a 'Day of Service' in which young people from local churches met families that we are working with and spent the day with them. One of the churches, which meets in South Mumbai, sent 12 young adults to this programme. A number of these young men were the ones who saved Bill. Literally.

Bill has almost starved to death. He suffers from mental confusion. His story is one where loneliness and success cross paths, with multiple side alleys of alcohol, women and drugs. Its also a story of a man very hungry. Hungry for love and acceptance.

Bill is by profession a dentist. A man who had the money flowing in - and who lived the life of the yacht, house by the lake, parties on him etc. He also is a man with deep rifts with his parents - a rejection of his father and mother - and a desire to find himself. Finding no way out in his town of 30,000 - and having already been admitted once with an overdose, Bill decided that India would give him the truth.

The story gets even more hazy here, but it seems that over the past months, Bill has been wandering a lonely path, observing, thinking and gradually losing control.

Talking to him, he was most lucid about his Canadian past - and his fear and loathing of going back. How starved for love this man is.

Bill has tried everything possible to live a good life, to not harm anyone, to be kind and benevolent. And yet things were clearly spinning way out of control in his own country - and he has been blended here.

I found myself going back to what Jesus said: "Come to me, all you who are weak and heavy laden, and I will give you rest." Its something that I have often shared with my friends who have HIV - who are staggering under the crashing loads of confusion and guilt.

As always, I can't solve Bill's problems. It is hard even to fully understand how much of what he is saying is true, but I do know that Bill desperately needs rest. Rest for his battered, emaciated body. Rest for his spinning mind. Rest of his love-starved soul. Rest for Bill - a precious child of God - wandering far from home - perhaps without a home.

We prayed together before I left. I think I saw a bit of rest in Bill's eyes as he thanked me.

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Just before I went, Simon, an elder from the church who has been shepherding the effort to help Bill, brought Bill some ice-cream. Bill cried and said that he had been craving ice-cream all day.

Monday, 4 January 2010

Another passing

Mrs. Naina died in the fag end of 2009.

She died alone. In the bowels of the HIV ward of a large government hospital in Mumbai.

Its very hard.

We had known Mrs. Naina since February 2007. A Bengali lady. A widow. She struggled long and hard with her HIV.

There were some bright points in the journey. Mrs. Naina seemed to respond well to medication for TB and the ART that aimed to keep the HIV levels low and allow her immunity to rebuild itself. Our staff met her repeatedly in the tiny hovel she stayed in. There were real smiles many times.

But all through, Mrs. Naina continued to struggle with her health. She was weak. She had chronic urinary incontinence which severely limited her ability to work. Her brother and sister in law moved from Kolkota to look after her. They went through ups and downs with her.

Finally it was becoming clear that Mrs. Naina was just not going to get better. We tried to provide palliative care at home. Mrs. Naina was angry. Her brother and sister did not want us to be there. Neither did Mrs. Naina. They began treating her at private hospitals and admitting her at the government hospital in Thane.

They hired a lady at Rs. 300 a day to stay with her in the hospital. Mrs. Naina recovered a bit but fell sick shortly after.

They finally took her to JJ.

She died alone.

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We have had a hard start to 2010. The fireworks went off all around us, but we feel tired and drawn. It is very important for us not to lose hope. To stand up for each other and to focus our eyes on God who provides real comfort even in situations of extreme grief and apparent hopelessness.

Though we wish we could rescript the last few months of Mrs. Naina's life - we have over the past 2.5 years had many wonderful experiences with her and her brother and sister-in-law. She loved God and held on to His hand. We know that she is at peace now - and look forward to meeting her again.