In a Desperate Place, He Gives More Grace

What a week. A long, beautiful, messy, tragic, inspiring, heartbreaking, overwhelming, tiring week.

I had the privilege of working with World Reach Partners medical team that came to serve Arise Africa International. 6 days of village health clinics. 4200 + people treated. Over 1,000 people gave their lives to Christ. The gospel was preached and pastors and churches discipled. There were highlights and discouragements. Challenges and victories. But the thing that stands out to me most, is the way that the Lord carried me, loved me, and showed his faithfulness to me during my weakest moments.

One day in particular, I was struggling. We were serving in an area very near to where I stay in Bukaleba-close to the babies home. We set up clinic in a school that was in session and had  released their kids from classes due to the disruption of us being on the property. Curious children who knew me well hung on the window bars, shouting and laughing as I tried to work, reaching in to grab my hair or what ever they could get their hands on…desperate for attention. People who were not truly sick were dodging the registration process in order to be seen first, while a mother with a critically ill baby was forced to wait several hours before presenting to us.

I was tired, hot, and frustrated. I wondered what kind of a difference we were truly making as I tried to see as many patients as possible in the short time we were there. We sent the sick baby with malaria and pneumonia to the hospital, and prepped to take a severely burned child to a hospital in Jinja for surgical debridement.

We were loading up the bus to go home, and Pastor Nelson called me over where a woman was standing under a tree. My heart started beating so fast because I recognized her. She was the mother of a 6 month old little boy who I had taken to the Neuro Hospital in Mbale for surgery for hydrocephalus. Most unfortunately, the child did not survive the surgery. Although Arise Africa helped this woman to travel home (which was in a very far away village) for the burial of the child, I had not seen or heard from her since the day we had taken her to the hospital. When I had heard that baby boy “Chosen” had died, I had so many different thoughts and feelings. I felt so much sorrow for this mother who was alone 3 hrs from home with a now dead child. I wondered if she blamed me for taking the baby to the hospital and thereby was going to blame me for his death. I had wanted to go and see her, and hopefully encourage and love on her. But up to that point I just hadn’t had the time. And now, here she was. She smiled at me and instantly hugged me tight. She told me that she was so grateful that Chosen was safe with Jesus, and it was so comforting to know that we tried to save his life. Tears overflowed my eyes, and I told her what a strong woman she was, and how much it meant to me to see her.  And it was in that moment I realized…what I do here does make a difference and it matters. Despite the hard and frustrating moments, He is here, and He is accomplishing the work He has prepared me for. It doesn’t always end like I would’ve planned, in fact it rarely does. But knowing that our God has the power to make the broken beautiful and useful in His kingdom is what keeps me going.Chosen



Another day that was challenging was a day where we went very far out into the village in Kaliro District. It was very hot and dusty. We tried a new triage system which worked great except that it kept me extremely busy. Even so, it helped us see more patients than we had before. Now, it was nearing the end of the day, and I turn around to see a young father holding the hand of a small child. The only thing that I immediately noticed was that the child had ascites ( a condition where excess fluid builds up in the abdomen). His case, however, was the most severe I had ever seen, and to see it in a child was even more difficult.

Ascites Child


I asked a lot of questions as I assessed this little boy who I found out was 6 years old. He was in obvious respiratory distress and extreme pain. I went to assist him to sit in a chair, and the boy screamed loudly and began to cry. His tiny little arms were skin and bones, and literally were too small to support the excessive weight of his large stomach. The father reported that he had sickle cell anemia and a heart condition that was diagnosed at 8 months. The fact that this boy had made it this long was amazing to me. But looking at him, I couldn’t imagine him surviving much longer without intervention. Ultimately, however, this child would not survive. He needed a heart transplant which isn’t possible here. My hope was, that if we took him to the hospital in Jinja that we would be able to have enough fluid drained off so that he could at least breathe easier. So, we packed up the van and left with him, his father, and his uncle. The rough village roads were nearly too much for him. He would let out a soft little moan with each bump, and his attentive and loving father would try to reposition him to a more comfortable position.


When we reached Jinja, we went to the first place we could think of, and that doctor refused to help him, saying we needed to go to the Children’s Hospital. When we reached there, we wandered around looking for someone to tell us where to start. After about 15 minutes of searching, we finally found the “Emergency Room”. It is a scene that is familiar to me but I never get used to it. Three children to a bed with their mothers sleeping on the dirty floor below. Feverish and malnourished children cried out in pain. Two nurses were on duty to care for about 60 children in a very small room. No sheets on the beds, no chairs for the tired mothers to sit in, no IV pumps to safely deliver fluids and medicine to the most fragile of patients. No oxygen for the ones who couldn’t breathe, no monitors to warn of a patient’s declining status. No cafeteria to bring food and drinks (in fact mother’s were cooking over small charcoal stoves outside). No indoor plumbing or running water. No mosquito nets for the beds of the children already plagued with malaria. I look over at Smooth and say “Welcome to hell.”

I see a nurse attempting to start and IV on a very dehydrated child using a broken piece of dirty IV tubing for a tourniquet. She uses the same gloves as she moves from child to child. I ask her if the doctor is around, and she says “He’ll be back at some point” Without looking up from what she is doing. “Go and ask that other nurse.”

We walk to the other side of the room where a younger nurse is working on inserting IVs and giving injections. I ask her if she can help us. She takes one look at the boy and is completely unfazed by his condition. The little girl she is working on takes one look at the boy and cries out of pity or maybe fear. She tells me to have them wait outside. “Musao (nurse),” I say gently but firmly, “My fear is that you will forget about them if you place them in the hallway.”
“For sure I will forget about them.” She replies with little to no emotion. “Tell the father he needs to come and remind me he is out there.”

I want to yell, scream and cuss. Nobody cared about this critically ill child. NObody. I was standing in a filthy dirty room that was poorly lit, overcrowded and understaffed. People were literally chasing wild dogs out of the wards. The smell of body fluids, blood and old wounds could make the strongest stomach turn. What could I do in this moment but tell them to wait? We explained to the father that he needed to keep checking in with the nurse, and we headed to the car. In the parking lot, we saw a well dressed man with a stethoscope draped around his neck. Smooth approached him and asked him to help us with the little boy. He was very kind, and came in to where the father and son were waiting. After assessing him, he promised he would care for him first. I assured them that I would come back to check on them that night.

A couple hours later, I went back to the hospital. Sleeping mothers formed an obstacle course all in the hallways and in the Emergency Room. I finally saw them just outside the door. The doctor had drained about 500 mL of fluid from his abdomen, and the little boy’s breathing had improved. They were very grateful for the help, thanking me over and over again. I assured them that I would come back the next day to see what the plan was for continued treatment.

I went back to where I was staying and laid down to sleep. But I couldn’t stop thinking about the scenes from the day…the week…the past month. All of these desperate and hopeless scenes played over and over in my mind. My heart literally was so burdened and too hurt by all I had seen to cry. I sent a very real and raw text to a friend in that moment:

“It’s only Jesus who carries me through these days. But after seeing this child, I can’t think straight. As I walked into that overcrowded children’s ward tonight to check on him where there were three in each bed, stepping over multiple mamas laying on the filthy floor, seeing the same blood infusing that was infusing 4 hours ago, hearing miserable cries from babies who barely have the strength to do it…I thought I was ok until I laid down in this bed…but I’m not ok, and it’s not ok, and it’s only Jesus who can move me from this bed tomorrow.”

But, His mercies are new every morning and he did move me from the bed into another challenging and tiring day of ministry with the team . That evening I went back to the hospital and I wish I could give you a happy ending. But he was nowhere to be found. Someone recognized who I was looking for and told me they went back to the village against medical advice. They were gone. I don’t understand why. It makes no sense. But they were gone. Ultimately this little guy will go to be with Jesus. It was my hope and prayer that some way we could make that easier for him, help this family in need. But without warning or explanation…they are just gone.

It’s moments like these that exhaust me mentally, emotionally and physically. You do everything you can, and it’s still not enough. So often I find myself saying things like “If we were in America…we could do this or that. We could test this or that. We have heart transplant surgeons and CT scans at every hospital, and if a service isn’t available at one place we will fly a critically ill person somewhere which can.” And often times I am tempted to think if we were in the US, I could save this one.

But the Lord is really breaking me down and teaching me that HE is sovereign over life and death. That he alone has stamped an expiration date on all of us. And no matter if we are in a village in Uganda or a University Medical Center in the United States…He is the one that puts breath in these lungs.

I have seen and heard of so many desperate cases here in Uganda. Children and young people dying too young. Dying of preventable diseases and complications of illnesses that could’ve been prevented. But I have also seen miracles. I know people who are alive today and shouldn’t be.

I know a man who has been struck by lightning TWICE. And he’s alive and well.

I know a 13 year old little girl who had brain damage from cerebral malaria with no hope give to her for her recovery, yet she testified while standing in front of church, singing a praise song to the Lord.

Several of our children were written off for dead when they were so sick and malnourished, and now they are alive and well-smiling, running and playing.

An old man whose flesh was literally rotting off of his body and very infected was literally made whole in a week.

God is in control here in Africa just as he is in America. HE alone is the hope for this dark and hopeless place. I am just a tool he uses…a vessel…that sometimes he uses to help heal, touch, and restore. I will never understand why there is so much in the West and so little here, but I know I have seen, felt, and heard from Him most clearly here.

In these desperate places, He gives more grace. And I am quickly becoming addicted to witnessing the way He will display His glory next. In the good moments and the bad, He’s always been here. Never making us walk alone, or leaving us on our own. “You are faithful, God you are faithful…”






5 Responses to In a Desperate Place, He Gives More Grace

  1. Betty Sizemore June 22, 2014 at 8:29 pm #

    Ashley thank you so much for letting me “see” a little of what you do each day. I have learned so very much from you, Smooth and Kelly. We are privileged in America and to get a glimpse of what you endure in Uganda is heartbreaking. But God is in control and always will be. HE is good all the time!!!

  2. David Ferrero July 8, 2014 at 4:23 am #

    One can’t help but fall on our knees in desperation and awe of the living God who alone gives us the only reason to carry on. Thank you for being the hands and arms of Christ.

    • Ashley Elkins October 25, 2014 at 10:31 am #

      David, thank you so much. You and your family have been such a blessing to me!

  3. Lance Lynch July 13, 2014 at 5:54 pm #

    I’m so proud to know you and am always inspired by reading what you share, Ashley. Thank you.

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