When we closed the clinic a month ago, the local leaders, in our first meeting on the subject, said “You have to open the clinic, otherwise people are going to die.” It’s easy to dismiss this as a rhetorical flourish, a hallmark of Karimojong oratorical style. There is a hospital just up the road, seven kilometers away. In another direction at perhaps four kilometers, there are not less than four retail pharmacies, where one can buy seventy-five percent of the drugs that are stocked at Akisyon a Yesu, and which are staffed in most cases by nearly-competent healthcare workers (at least two who’ve been previously employed and subsequently dismissed by AYPC). In addition to this, AYPC has still kept staff on call to handle emergencies brought to our door and conduct deliveries for women who come in active labour.
Nevertheless, aside from being a helpful stick to wield, the thought that someone might die because the clinic is closed remains a real possibility. In fact, in the last weeks, we have handled several cases of malaria so severe that the children were seizing. One of these cases was the child of the local chairman who oversees the area where our pump was stolen, and who has been sitting on his hands rather than assisting us in the investigation. When I was called down to unlock drugs that his child needed, and I informed him that we were only going to stabilise the child but that he would have to take him to the government hospital to complete the treatment, the look on his face was pure incredulity. It spoke volumes about his perception of the mission, the missionaries, and the clinic. He truly believed that all our words have been mere bluster and that he would not feel the pinch that his failure of leadership has brought about. Maybe if his child had fallen sick on day one of our shutdown, he wouldn’t have wasted the first two weeks of our closure doing nothing.
Others have been forced to walk long distances at night for care, or to pay exorbitant prices from the local pharmacies (who, sensing a major windfall in our closure, took the chance to raise their prices), often being taken advantage of by the pharmacists’ usual trick of upselling unnecessary treatments. The outcry for us to reopen the clinic has been very real, and in no wise superficial.
One of our workers has had terrible eye pain for several weeks. She was almost completely unable to see several weeks ago. She went to the pharmacy and got eye drops which have helped, but still remains in pain and without a proper diagnosis. I found out this week that she has known for some time who the culprits are, but she hasn’t come forward either to me or to the police with that information. And she is not alone. By now, it has become clear that the names of the actual culprits are widely known in the community (which we always suspected, but never had concrete proof of). Taken as a whole, then, our community is absolutely complicit in this crime, and the suffering that they have collectively had to endure has fallen justly upon them.
Undoubtedly, someone will quote me James 4:17— He who knows the good he ought to do and does not do it sins. If we the mission have the capacity to treat sick people and refuse, isn’t that sin? That this verse has been ripped from its context aside, a simplistic reading of these words is naïve at best, and in Karamoja, positively dangerous. This surface-level interpretation rests all its weight upon the idea that the good we ought to do is clearly knowable and known. But are things so simple? Helping our neighbours by providing healthcare must absolutely be balanced against our other commitments, not least of which is the importance of exercising good stewardship over the church’s money which has been entrusted to us. I suspect that if we made an annual request for a “generator (to be stolen),” people would wisely avoid donating. Leaving that obvious objection aside, our main purpose in being in Karamoja is not to provide healthcare, but to plant a church, and to encourage Christian growth. It is possible that continuing to operate our clinic under the current circumstances undermines that project in several ways. It allows our community to sidestep the need to do the difficult work of loving their neighbour by refusing to harbour miscreants. Our laxity in pursuing justice may provide a temptation to anyone fallen on hard times to view robbing the mission as an easy way to improve their financial situation. Our corporate meekness may undermine the message of God’s justice in a culture where sin is so casually brushed aside.
That said, the decision to close, from the beginning, has not been easy, even for the most calloused on the mission. Watching those we consider friends suffer does test our resolve. The question of whether or not we have done the right thing is perpetually in the forefront of my mind. But maintaining the status quo is all too easy. Perhaps a less-constant stream of handouts from the mission will really separate the wheat from the chaff at Nakaale Presbyterian Church. Perhaps our presence here will be better understood. We cannot allow uncertainty about outcomes to paralyse us from making big decisions. All we can do is try to be as sensitive as possible to the leading of the Spirit, and open to the wisdom of our church members, clinic staff, neighbours, and government leaders.
Nor has the process lacked any brighter side. I have come away from it with much more clarity on how the structures of power in our district operate. I am on familiar terms with far more government officials than previously I was. I understand better how to guide a matter through the bureaucracy in order to get results. I’ve had several chances to wrong-foot the village leaders in discussion, who are so used to shouting us down and getting no push back.
Bruno Novelli, one of the early Catholic missionary/sociologists to Karamoja, whose insights into the culture are a treasure for all of us who have come after, has this priceless passage at the beginning of his book on the Karimojong:
“It is good to know that for the Karimojong, there are three kinds of people: friends, who live with the Karimojong, and who are considered as equals; enemies who live like the Karimojong and thus vie with them for the resources which guarantee life for both man and beast, and who therefore must be fought; and all others who, because they are neither friends nor enemies are neither considered equal nor are they fought, they are strangers, good perhaps to be exploited when useful to the Karimojong.”
How piercingly that comment strikes at much of the ministry we have done in Nakaale. As long as we are relegated to the ranks of the strangers, our ministry cannot drive home in the hearts of this community. While we acknowledge that God can use any means he chooses, for our part, discipleship will always be more fruitful when it comes from a trusted friend rather than a preacher hectoring passersby on the street corner. It has been my constant appeal to our neighbours during this time that we are not strangers. We are in fact their friends, and the closure of the clinic is an appeal for reciprocation. Either we work together as friends toward the common goal of having a clinic which is able to operate well, or we shake the dust from our feet and try something else. No one wants to be a stranger forever.