What Makes A Healthy Nation?

This question was raised again in my mind by a recent experience traveling in a remote district of northern Uganda (Pader) with some visitors from the UK and USA, where we encountered Jacqueline, lying unconscious by the side of the main dirt road. Her parents were unavailable, being some distance away, working their garden for food to eat. Her brother was around. A local government administrator was also passing by on a motorcycle and acted as our interpreter. Thankfully we also had two doctors on board our vehicle. God had his hand on this girl, with time, place and people coming together in perfect harmony. Eventually, we all agreed that she should be taken unconscious to the nearest medical facility. We reached the best clinic in the town after my twenty minute “ambulance” style drive. It was a newly built, free facility, with an outpatients clinic and one inpatients ward. There were at least two hundred adult outpatients, mostly mothers, with at least a further two hundred young children. There was only one nurse at “triage” and one doctor attending to them all. Both of them stopped their work to attend to our patient. Everyone else waited patiently for their turn to get served – real out-and-out patience. I realized later that we had jumped a seriously long queue – a very non-British practice, but one for which I was thankful to all my Ugandan friends who might still be there waiting. The Doctor said that he had thirteen nurses available but he had given up trying to persuade them to come to work.

We later learned that Jacqueline is deaf and dumb, was suffering from a combination of epilepsy and malaria, and had just experienced a major seizure before we arrived on the scene. They put her on a drip in the ward and she regained consciousness some time after we left. She is now reported to be home again with her family. Where am I going with this story?

I can remember as a boy, loving the biography of Florence Nightingale (1820 – 1910), caring for dying soldiers in the horrific Crimean War, and her example setting the standard and inspiration for the nursing profession, founding St Thomas’ Hospital, London, in 1860. I can remember my mother telling me how this had inspired her to become a nurse. This spirit was further demonstrated to me by historical accounts of self-sacrificing medical missionaries over the last hundred years on the continent, working to eradicate leprosy in Uganda, for example. Considering that Florence and others were volunteers, committed and compassionate, I realize that today’s health workers are motivated by different forces. It is often less of a vocation and more of an employment, providing a means to survival; the by-product being community health, of a fashion. I am generalizing of course and cannot assess the motives of all medical personnel everywhere. Certainly there are some outstanding doctors in Uganda, whom I respect very highly for acting professionally and sacrificially despite extremely limited resources and challenging working conditions.

All the same, you may be aware of many African health workers who have flown away and are employed in the UK and other “developed” nations. Why? Because the stress of caring for so many people at once, the magnitude of the health problems associated with poverty, the unreliability of the wage, the scarse equipment, and the meager medical supplies; all contribute to an exodus from the nations that so badly need their services. The health sector in Africa is so badly in need of people committed to community health and the welfare of their own people. In reality, poor people are often just as concerned with themselves as rich people are, and that includes health workers. Furthermore the health budgets of governments in such countries are highly politicized, being stressed and stretched by many other demands, including education, security, infrastructure, administrative bureaucracy, systemic corruption and stately opulence.

Healthcare in Africa is a complex subject area that I cannot begin to fully address here, but some thoughts I can offer. The good thing about the clinic in Pader was that the services and treatment were free to the local community, being supported by an international medical foundation, who paid the doctor to be present. It is also interesting that Western governments are now recognizing the problem; that their international aid, aimed at assisting primary healthcare might be better invested in assisting personnel to stand in a primary position within their own countries. If Uganda is anything to go by, there is plenty of money to build clinics, but there are just way too few medical personnel available to offer even a basic service to the people that the buildings are supposed to serve. This was confirmed a few days prior when one of our doctors visited an unmanned “clinic” in Padibe; it was like visiting an empty vending machine. Buildings can never make people better. Healing hands can! Local people need professional and compassionate people, speaking the same language, to offer them these vital services. We really need all people in Africa to see their role as meaningful to the development of the nation, from the president, through the local government worker, across to the nurse extracting blood for laboratory testing.

I wish to suggest that Nation Building should be at the heart of all sectors of society, and is the heart of the matter in Africa’s development. I believe this is a foundational principal found in the Bible – nation building. Some of our major biblical heroes were highly commended for building nations outside of Israel’s personal interests. For example, Joseph helped Egypt assist nations outside itself with food supply long before the World Food Program, during a time of severe regional famine affecting at least north Africa and the Near East; Daniel served the interests of the Babylonian kingdom, Israel’s greatest enemy, to advance regional trade and development; and Esther was “born for such a time as this” to save Israel, a minority people, from genocide. We should not forget Jesus Christ, who evidently left the comforts of heaven to enter a poverty stricken world, teaching selfless ethical principals, healing ALL the sick wherever he went, and leaving no-one untouched by his encounters. It takes a sense of calling or vocation, with much grace, but it must be pursued by sincere followers of Christ, at least according to His foundational reference manual – the Bible. We need people who will serve the needs of others and not just be concerned with survival, or self-serving interests. The mindset that poverty creates is a serious health risk to Africa’s people, but “with God all things are possible!”

Prosperity Costs

Who would have thought that the favour of God upon your business could cause sinful emotions to rise up around you, leading to murderous intent in the heart of your opponents? If you have ever experienced malicious opposition in business, this would not surprise you at all. But, an opposition that leads to dying for your faith; is that how far we are prepared to go in exhibiting God’s favour upon the work of our hands? I wonder how the proponents of the extremes in Prosperity Gospel would handle this story and whether they would be prepared to go to these lengths for Jesus?

A man in Pakistan, Rasheed Masih, of Khanewal District, Punjab Province, is reported to have been murdered for being successful in growing potatoes, although, in the process, there is a demand for his conversion to Islam. The man’s success is attributed to his faith, since he was expected to convert to Islam or die for his success. This indicates a hatred for the Christian God who made his land fertile.

Certainly, I believe this man’s agricultural business was successful as a witness to the community around him of God’s favour on the work of his hands. Yahweh spoke to the Israelites in Deuteronomy, saying, “The LORD (YAHWEH) will send a blessing … on everything you put your hands to … Then all the peoples on earth will see that you are called by the name of the LORD (YAHEH).” (28: 8, 10)

I have heard of hatred and malicious practices being set-up against God’s children in sophisticated business environments. Nevertheless, I could not have predicted that fruitful production in a simple garden would lead to martyrdom for the sake of the Gospel. It brings a whole new meaning to “Faith like potatoes” (film based on a book by Angus Buchan). Perhaps the man’s convictions would not allow the glory of his success to be attributed to the name of another god? More than that, perhaps he would not relinquish his personal devotion to a God he knew, in exchange for another god he was not personally acquainted with? The secular world and inter-faith movements deny any difference between YAHWEH and Allah – they are both called “God”. This story distinguishes the devotion of followers and exposes the spirit of each “God”. Clearly, the spirit of Yahweh is different to the spirit of Allah. If they were the same, there would be no need for jealousy or murder, but only rejoicing in a shared abundance.

I was listening to George Beverly Shea last night in an interview (he is now 100 years old!), who wrote a beautiful song that my brother, Rasheed, might have thought, “I’d rather have Jesus than silver or gold … than to be a king of a vast domain. I’d rather be faithful to his dear cause. I’d rather be true to his holy name. I’d rather have Jesus than anything that this world affords today”.

What's in a name?

We have just encountered the celebration of a special season for those of a certain faith here in Uganda. One might initially think that I am talking about America’s Thanksgiving season, which has just passed and is often viewed synonymously with what God has done for a nation.

I’m actually refering to Idd-al-Adhuha, which is the Muslim’s celebration of Ibrahim (Abraham) being asked by God to offer his son Ismail at an alter on a mountainside somewhere in today’s land of Israel, close to Jerusalem. Thankfully, Allah provided a ram as an alternative to Ismail. Muslims celebrate this by sharing meat; one third for their own family; one third for relatives; and one third for the poor. This commemorative feast also launches Muslims into their new year. It’s a four day festival. Idd means festival, and this one is different to Idd-al-Fitri, commemorating the end of Ramadan.

At first glance, this might be regarded to be so similar to the Jewish story of Abraham’s predicament with his son on Mt. Moriah, that one might be tempted to think that we have so much in common and we should agree with the ecumenical sentiments; that at least three faiths lead to the same God. That Judaism, Christianity and Islam all lead to the same divinity, though carrying differing names; Jehovah, God and Allah. We might think that there is a minor discrepancy in the stories; one son being named Isaac and the other, Ishmael. So, what is the problem with differing names in each story?

Amazingly, mount Moriah is almost certain to be in the same range of mountains around Jerusalem on which a certain Yeshua (Jesus) died as the slain lamb of God. On the same mountainside, where this time God did not offer any alternative, since there was none available. No other could provide righteousness for a people who put their faith in this better son of Abraham, son of David, son of Man. “But where is the lamb” asked Isaac, to which Abraham replied, “God himself will provide the lamb” and “on the mountain of the Lord, it shall be provided” (Genesis 22: 7, 14). When Jesus walked into the Jordan river to be baptized by John, he declared, “Look, the lamb of God, who takes away the sin of the world” (John 1:29).

What is the difference between the two sons of Abraham? Are they not one and the same person in two different faiths and holy writings; the Qur’an and the Bible? Well, in at least one of these books, their unique identities are unmistakable and host dramatically different destinies. There is no doubt that Jehovah affirms both Ishmael and Isaac as fathers of nations. There is also no doubt about God’s compassion towards Ishmael’s mother and his designed future for her son (Genesis 21: 13, 17f). Nevertheless, it is Isaac who becomes the heir of divine promises (21:12). Furthermore, those who put their faith in Jesus are clearly distinguished, not as sons of the “slave woman” (Hagar), but rather as sons of the “free woman” (Sarah), of a new and better covenant, and of a life in the promised Spirit of God, not in the laws of religion (Galatians 4: 21-31) .

We can certainly enjoy this festive season of thanksgiving for the special son of Abraham, Isaac, and his greatest descendant, Jesus, the most potent sacrifice of all, whose meat we eat and who continues to pour out his Spirit of joy on all those who pursue this Truth (John 6:53).

Desperate for the Diaspora “Kyeyo”

One bold fact shared on Independence day 2009 by our respected president, under his comments about the economy, was the amount of money entering the country from the Ugandan Diaspora – a staggering $500m, estimated to reach $700m by the end of the financial year (if I heard him correctly). This may not seem much when measured against the mighty West, but it is a significant proportion of the national GDP.

More staggering to me are the reminders in the Monitor newspaper the following day, under a section dedicated to relationships, of the great procession to the marital grave by those separated through “Kyeyo” (“graft”). Instead of marriage achieving its intention of grafting people together on a single, fruitful plant, people (men mostly) separate from their partners and children for years, offering very little in the way of counsel or regular communication, for the sake of that elusive pot of gold in Europe or America that is supposed to transform their lives forever. Poor communication often stimulates justifiable mistrust back home, while the grafter sometimes enjoys a second partner in their new-found “promised land”.

Instead of being fulfilled as a present household leader, men sacrifice God-given opportunities to grow their children and nurture their marriage, for a distancing financial security. The most financially secure person among them is the one abroad and definitely not the children or the partner, who put their trust in God, and wait for the next Western Union message to keep them afloat for a few more weeks. The humanitarian solution would be their reunification in the new land of promise, since Africa is apparently destitute and diseased, often considered a large proportion of the “Third World”, and a last option for any immigrant.

I fully understand that money is important and the cost of living is far from cheap in Africa. However, I am trying to understand what principles a Christian should adopt, which God might bless; and what principles he might not bless, according to my reference manual (the Bible). I fail to understand from a pastoral perspective why separation through long-term economic migration would be the best solution for any family, however difficult things might be at home. I cannot find an Old Testament example, nor a trace of justification in the New Testament for a husband and wife separating long-term (help me if you can). Furthermore, faithfulness is not simply a form of chastity in Biblical terms. Neither is fatherhood an economic term.

By its very definition, fatherhood is a pastoral term, and a role that requires close proximity to its subject, to whom he is required to administer direct contact and attention. The husband, even in a horticultural sense, requires a close proximity to his garden in order to offer personal, tender care. God, who is both our father and our husband spends time attending to our needs in all respects. Perhaps God himself is not seen in a relational sense by some, but is regarded simply as the provider. Surely this minimizes the presentation of his character as the father who gives us “everything we need” for life and who carefully attends to the vine for its fruitfulness (2 Peter 1:3 and John 15). We would be Deists if we thought God was a distant father and husband, whose only regard was for our economic needs and only responded when we cried loud enough, to which he responded by tossing a loaf of bread every now and again. What kind of God is that? Definitely not the one I serve, talk to, and live for.

If we continue to argue the merits of “grafting” from an economic perspective, I remain troubled. If I argue for reunification in the “promised land”, I would be very unpopular with then nationalists. Maybe there is another angle? Africa has experienced a cyclonic brain drain in the last twenty years that has left African nations and economies bereft of skills and personnel in vital areas such as the health sector, educational services, social services, security services, never mind corporate business. But, we surely must cease to blame this Exodus for a problem only resident participants can resolve.

On a recent visit to Rwanda, a young lady impressed me with a statement: “We Rwandans never used to think much of ourselves, and other nations despised us wherever we lived. But when we finally came home, we realized that we were the only ones who could make a difference in our country; and that is what we are aiming to do, no matter what other people think of us.” There is no doubt that nation building is costly on its indigenous participants, but who else is responsible to do it? The truth is that no-one but Africans can rebuild Africa in the long-term. Foreigners have tried, but they leave when it gets too hot and the indigenous people are left unprepared.

I will stick my neck out as an idealist and suggest that if all the Diaspora who are sitting on the fences of North America and Europe, demanding a better government back home, were to courageously return to their respective countries with the knowledge, experience and skills acquired, intent on making a difference, Africa would be transformed within the following twenty years. May I continue with my idealism and suggest that we need national leaders at all levels genuinely pursuing Nation Building. This would be a stronger position than to boast about income from the Diaspora. That is simply another dependency on external forces.

How can a nation be built on the presidential statements and plans of one man? That is impossible. We need a people committed to transformation at all levels of society, from a minister of government to a primary school teacher. We need people with transformational vision at all levels of leadership. We need people with honourable values. We need real Christians from among the 80% religious adherents of the populous, who will stand up for what the Bible actually teaches and not what they can get out of God for themselves alone. We need husbands and fathers who put their family first, by being present, injecting integrity first-hand. We need nurses who will put the health of their patients first. We need doctors who will keep to the hypocratic oath no matter what. We need procurement officers who will not pay out money for things they never bought. We need policemen who will not compromise the law to meet personal needs. We need businessmen who put their customers first and not their personal wealth (certainly that is a tall order). We need city pastors who will put their people first and not make ministry their personal property. We need those at every level and in every sector, who will keep to their sincerest promises, “for God and my country” (Uganda’s motto), even when it hurts (Psalm 15).

Kingdom Clash

It is much more peaceful in Kampala today, since the Kabaka (King), Ronald Muwenda Mutebi II, decided against his preferred intention, to go to Kayunga. He has only postponed, not cancelled his planned visit. So, what did cause the recent eruption of violence in the city of Kampala?

The problem is complicated. Basically, it is a clash of powers between the cultural leaders of a major people group, the Baganda, and Uganda’s central government. The presenting issue is one of security, when the safety of the Kabaka is deemed to be under threat, due to his planned visit to a sub-people group of Buganda, called Banyala, who no longer want to be subject to the King's rule. The Kabaka insists on going to survey this part of his kingdom, but the government says he cannot go due to safety risks. The Banyala are said to be ready with pangas/machetes for his visit (a multi-purpose 12-inch knife). The president ordered a military road block to stop entry to the area by a Buganda delegation earlier this week (one day before the riots). This is considered to be heavy-handed, since they would prefer a security escort, rather than a blockade. It also rubs salt into the festering, prideful wound of subordination that the Kabaka and his rulers are nursing. People came to Kampala and started protesting against this impingement upon their considered right to freedom of movement; most especially that of the King’s movement among his people.

The contention for the Central Government is that the various Kings and their Kingdoms in Uganda are not supposed to have any political ambitions. The constitution established in 1995 has a specific entry preventing cultural leaders from pursuing political ambitions. It was intended to save the country from future chaos similar to that ensued in the early days of independence, when there was a serious clash between president Obote and the Kabaka, Muteesa II, leading to the king’s exile to Britain. These “cultural” kingdoms were only re-introduced in 1993, since those problems in 1967. Cultural leaders were consulted when drafting the constitution and consented to this principal at the time. Kings are simply not allowed to get involved in political matters (according to the 1995 constitution, section, 246, 3 (f)). The Kingdom’s media house, CBS (Central Broadcasting Service) is renowned for being outspoken against the president of Uganda and was shut-down this week for inciting the protests.

Despite Buganda’s political restrictions, the kingdom has its own sub-system of government, directly related to land management throughout the kingdom. They have a parliament in which sit representatives from their 56 clans. It is a huge geographical area they claim dominion over. There is also a long-standing demand by the Buganda kingdom for “Federo”, or the creation of a federal state system of government (like Nigeria). The King and his kingdom have political ambitions for self-autonomous rule and this incident heightens the disagreement and serves an opportunity for the Central Government to be undermined by the instability; justifying their wish for a change of rule. Another problem is that the capital city sits within the Buganda kingdom and they claim the right to rule the city.

Riots are being carried out by disgruntled, poor young adults who have a reason to fight and little political motive, but who conveniently serve the purposes of Big Men. There could be other hidden factions (such as an opposition party) stirring the pot and arousing violence, in order to destabilize the city and undermine the government’s ability to rule, and accelerate their own political intentions. Democracy is certainly not in the minds of the perpetrators of violence, who prefer the baton, stones, bullets and burning rubber to the functional ballot box, where the choice of leadership should rightly be made.

From a biblical point of view, this is an example of “spiritual forces of wickedness in heavenly places” (Ephesians 6:13) working behind the scenes to manipulate society towards conflict, chaos and all manner of evil. Clearly a destabilized society gives room for anyone with a score to settle to hijack the opportunity to carry out violent and murderous acts behind the scenes. Politics is never simple, and power is the pursuit of the wicked in all camps.

Let the righteous stand up, since God’s “intent was that now, through the Church, the manifold wisdom of God should be made known to the rulers and authorities in the heavenly realms, according to his eternal purpose which he accomplished in Christ Jesus our Lord.” (Ephesians 3:10f).

We pray that the King of Kings will intervene according to his higher purposes. Certainly He will rule in the long run and the wicked at all levels will get their just deserts, whether in this life or the next. Without repentance and submission to THE KING, there is no remission for such sins. In the meantime, the undermining of those who lead this nation is not God’s will, since “everyone must submit himself to the governing authorities, for there is no authority except that which God has established. The authorities that exist have been established by God. Consequently, he who rebels against the authority is rebelling against what God has instituted, and those who do so will bring judgement on themselves. For rulers hold no terror for those who do right, but those who do wrong.” (Romans 13:1-3). If the Roman Empire with its iron-handed leadership and military brutality was believed to be appointed by God, what about the present Ugandan Government? Should we not be in prayer “for kings and all those in authority”, not in partisan fashion, but “that we may live peaceful and quiet lives in all godliness and holiness. This is good, and pleases God our Saviour, who wants all men to be saved and to come to a knowledge of the truth. For there is one God and one mediator between God and men, the man Christ Jesus.” (1 Timothy 2:2-5)?

Rain Stops Play

In England rain stops summer pleasures like cricket and tennis, but many other aspects of British life continue unabated by weather. With the exceptions of snow and hurricanes, the hardy men of Rugby and real football (soccer) fight on through the wettest afternoons. Rain shall not deter the stoic Capital man from building cities like Manchester or London. Come rain or shine, it’s off to work we go.

The sun shines in Uganda’s capital at least 75% of each day, 365 days a year. It's no wonder it was once the favourite god, prior to the coming of Christ through His classic missionaries in the late 18th century. Today, believers in Livingstone's Commerce are everywhere: on bicycles, motorcycles, in mini-bus taxis, on foot everywhere, crossing the roads left-right-and-centre. Street-side vendors every few feet of the pavement (sidewalk). People talking on public phones, informing their liaison they’ve arrived in town and “sorry I’m late – traffic jam”. Bare foot kids from Karimajong with begging hands and chants of "please sir, give me one hundred" cry at the stream of cars - babies slung around the neck for extra effect - a deadly aroma of guilt and contempt riding inside. A few appeasing coins slip over the top of slightly opened car door windows. Young men walk around selling daily newspapers, 2nd hand chinos, CDs of local music wannabes and pirate DVDs, cell phone accessories, mens belts, shoes, padlocks, peanuts etc, etc.

Women take steamed matoke or rice and beans from small cook houses to hungry customers in offices. Shoe shiners brush up several pair of smart shoes while the owners walk around their nearby office block in a set of rubber souls. From beggars to smartly dressed office workers, the town is the model of hustle and bustle. But that is when the sun shines.

When it rains it usually pours down and as the density of heavy rain drops rapidly increases, so does the pace at which legs move towards the nearest shelter. It is actually the only time you see anyone move so fast and the city streets cleared of pedestrians and motorcyclists in the blink of an eye. Perhaps the odd boda-boda rushes to drop off their last fleeting fare. Within a short time everybody has run for cover under the nearest pavement overhang, many clustered around the mail boxes at the main post office, or under an old colonial shop veranda somewhere.

It becomes a little easier to move around in your car. Tyres bounce better through waterlogged potholes and some drivers have pulled over because they don’t have the luxury of a working wiper-motor. Other drivers plough through the foot-high streaming streets like a sheep through Dip.

Nobody walks for fear of being soaked with a red-brown muddy wash overflowing from the silted dead-end drainage system. Everybody watches the rain, waiting for it to stop before anything resembling movement can recommence. Even those at their workstation will watch expectantly through the doorway or window wondering how long it will take for the Intermission sign in the sky to cease and permit business to continue as usual. Don’t expect full attention if you enter a shop. The excuse for lateness shifts from the traffic jam to the weather - African Time continues.

Rain has interrupted the rhythm of life and all eyes are on the heavy graphite cloud above. Within an hour the tropical nimbus has ambled north and our equatorial sun beckons the punters out to play their survival rhythms once again on the streets of this lively, friendly city, Kampala.