But much increase comes from the strength of an ox.
I read this proverb this morning. It does what proverbs do best, namely to pithily state something that is universally accepted, and then leave you to connect the dots.
Generally, I'm a fan of order. Unapologetically, in fact. There is something about bringing order out of chaos that rings of creation by the God in whose image the Bible says I am made. In the hospital, and outside the hospital, I spend a lot of time trying to solve problems. And oftentimes, those solutions take the form of trying to develop a good system. A system that documents medicine doses given. A system for determining how our construction projects will be funded. A system for approving student thesis research projects. These are all good things, and what's more, I think they are one of the significant contributions that I and my teammates make to various situations we encounter here. I see a well-functioning system in place and it feels so right.
In other words, I like a clean manger. Quite a lot.
Generally speaking, though, we do not live in a world of clean mangers. And by the way, this proverb is being ridiculously polite, and I think we all know it. I mean, yes, it's true that the oxen will leave the manger dirty, and there is a nice parallelism between the manger void of food and the harvest of food that the oxen produce. But we all know that the manger is not where the real mess is. Oxen leave quite a bit more in the stables before they go out to their work. The stable is not clean.
I can relate to that. For all fires I try and put out, or all the systems I try to put into place to prevent the next fire, things fall apart. The day feels like whack-a-mole. Even 60% feels super great sometimes. This world is good and fallen and messy. Our efforts at creative order in this world are good and fallen and... messy. Actually it can be quite dispiriting.
I like a clean manger.
Proverbs' personification of Wisdom walks in the door and retorts, "but do you like an abundant harvest?" I see where she is going with this. I glance up at her as if to ask "do I really need to answer that?" She looks back as if to say the same thing.
"Yes, I do," I say begrudgingly, but still appreciating the back-and-forth.
"Then it's going to be messy," Wisdom replies, "but that doesn't mean you're doing it wrong."
Aside from the oxen argument from the natural order, why is this mess necessary? Couldn't we be free to create order without it. Last year, I read these words from the late, great Eugene Peterson in his Under the Unpredictable Plant:
A group of seminarians I was leading on retreat once asked me what I like best about being a pastor. I answered, "The mess." I had never said that before; I don't think I had even thought it before. The answer surprised me as much as it did them...Actually I don't like the mess at all. I hate the mess. I hate the uncertainty. I hate not knowing how long this is going to last, hate the unanswered questions, the limbo of confused and indecisive lives, the tangle of motives and emotions. What I love is the creativity. And what I know is that I can never be involved in creativity except by entering the mess.
I think this is quite true, and I can relate to it. Thus, to act in imitation of my Creator, I will enter the mess.
Even more so, I think that I am (very slowly) learning that this is how we grow in trust. How should things be in this world? It's a good question, and part of the answer is that we are to be trusting God. And how would we learn to trust without things happening in a way that is other than what makes sense to us?
The manger is not clean. We need the mess.
One Kibuye way of expressing this over the years has been to reference "thorns and thistles". In Keller's Every Good Endeavor, he references these words in Genesis 3: "Cursed is the ground because of you; through painful toil you will eat food from it all the days of your life. It will produce thorns and thistles for you, and you will eat the plants of the field."
Keller's point is that sometimes our work in this world is full of hardships and brokenness, the "thorns and thistles". Why? Because the world is broken with sin. Why is that important? Because, though it means that the presence of such difficulties is a sign of something wrong (we know this intuitively), it does not mean that we are doing something wrong.
Yes, we have days like that. So you do, I imagine. We walk home and catch the eye of an old friend who happens to also be a teammate.
"How's the day?"
"Thorns and thistles."
A nod of understanding. Sometimes, it's a mess. But that's not a sign necessarily that you're doing something wrong. It may be an opportunity for creativity. An opportunity for trust. Maybe it means that the oxen are hard at work. We await the harvest. Courage as you wait.
This is an extract from the message I shared with our teammates at the start of the year. It has been edited slightly for this audience. I hope it will encourage you too.
(The essential is invisible to our eyes; it is only with the heart that one [truly] sees.)
God gave Kibuye Hope Hospital many good gifts in 2022. Not least among these is the presence of two Samaritan’s Purse post-resident doctors, Drs Ben Roose & Selina Thomas. We struggled in other areas of staffing last year, particularly without a DAAF, but specialist physician coverage was on solid footing. With four surgeons (plus some short- / medium-term help) and three family doctors, residency training moves forward. PAACS officially started their second class this month and FM is getting ready to submit their dossier for internal and external reviews. We also hosted five visiting residents/fellows in FM, ophthalmology, and emergency medicine, a record number for Kibuye.
When wells and fuel ran dry in the middle of the year, God brought us some amazing encouragement via outside support. MSF (Doctors Without Borders) took over paying for severe malaria cases. We performed 61 cleft lips / palate repairs (with the support of SmileTrain), put in about 300 intramedullary nails (a way to surgically fix a broken leg bone) from SIGN — making us #10 in the world, and enrolled over 30 kids in the only retinoblastoma program in the region (sponsored by SEE International). AMH (African Mission Healthcare) continues to support this work and help us fundraise for big projects like the massive Peds Building (which hit max capacity in its first year in usage, BTW). And of course our mission, Serge, continues to shower us with financial, logistical, and spiritual support. Our hospital was able to score maximum points in our quality of clinical care evaluations that happen every quarter. Things are getting better. There is much room to grow, but progress abounded in 2022.
For the year upcoming, I hope to see the hospital take greater strides towards community and organizational sustainability. Caleb is building our capacity to be totally grid-independent for water and power. Michael is setting the stage for an information technology revolution at Kibuye with distributed digital X-rays and improved charting / tracking software applications. With the new leadership structure of IMeLEA in place, we are hoping to move Kibuye Hope Hospital towards greater financial independence, with a large part of that being an upgrade to National Referral Hospital status. I’m personally committed to getting some additional quality measures in place and executed effectively.
Some of these are bold goals, audacious even in the face of years of struggle and difficulty to chart a new course, but I believe that God has given us the right team at the right time to accomplish these and many other good works in the year ahead. But I want to leave you with one number and one story that I think illustrate the best work we have to do here, that doesn’t require anything other than showing up for our patients, students, and colleagues every day.
That’s the number of patients whom God saved at the hospital in the last twelve months…at least that the chaplains know about. With the median US church attendance being 65 according to a 2021 study by Lifeway, that is like planting >23 churches in a year!
And maybe not all of those are new conversions or good soil that will bear fruit 30-, 60-, and 100-fold, but many are like Divine* (not her real name), a 32 year old woman whose husband left her when she delivered their 3rd stillborn baby. She was destitute and paralyzed by despair. Where could she go? What would she do? Yet into her dark cell of depression and abandonment shone a ray of hope from one of our chaplains. Could he pray with her? OK, I guess so.
He shared with her about true Hope. She repented of her sins and confessed Jesus Christ as Savior and Lord that day. That painful, horrible day had brought new life to Divine’s soul and she was released from the fear of the hex placed on her by a neighbor, freed from the shame of being unable to bear children and now being a functional widow, filled with a love everlasting that wasn’t at all based on who she was or what she had done but on who Christ is and what He did.
Let us press on into 2023 and pray that our Master and Friend will continue using us as He reaches into the brokenness of our world to bring forth beauty and grace!