Friday, January 20, 2017
I was reading a book my Amy Carmichael this week called “Gold by Moonlight”. Amy was a missionary to India in the 1800’s and gave her life to rescuing woman from temple slavery. She’s written more books than I could read as well as having penned hundreds of songs. Chapter 4 of the above is titled Snow. I am a Chicago girl first and foremost—December=Christmas=Snow. As you can imagine, there’s no dreaming of a White Christmas when you’re waking up in West Africa. Bing Crosby on the iPod has to suffice for this year. I will admit to looking up at the sky and asking God for one tiny unique snowflake to come down from the sandy sky and land on my tongue. Each time I promise to keep it our little secret, but it hasn’t happened yet. But in this Chapter, Snow, Amy writes:
And then suddenly—snow. And all our pleasant things are laid waste, or so indeed it seems, for we cannot see them anywhere, and all our newborn hopes are deep under the snow. For hopes had begun to be: a hope of healing, perhaps, if the trial be of the flesh; of a reversal of decision if it be something that lies in the power of another; or some touch on the wheel that turns our earthy affairs, if it concerns circumstances; of some break somewhere, some natural human joy, some relief, some comfort in the aching sense of loss—and now the snow has fallen and covered everything.
I read that excerpt right before New Years day and realized that nothing had more perfectly articulated what the emotional sum of the last twelve months.
Everything covered in snow.
But time continues and eventually the snow melts and gives rise to spring. Somehow we are given permission, either from ourselves, or others, to once again remember that which was sewn many months ago. There is nothing about 2016 that we need to forget, of course. There is merely a time to move forward in a healthy way, looking towards the joy of a new morning.
As I think ahead, I can only look back to the ways the Lord was already so faithful to me and to this community during the past year. Despite our great loss, the surgical service here never went without a surgeon. We took care of 46 new premature infants, all with Birth Weights less than 2 kg, with a survival rate of 89%! Our two boys, Martin and Jonathan, who are undergoing treatment for leukemia have successfully reached the 1-year mark—half way done! Our first ever HOH nursing class which began in May has retrained all of its students up to this point—a huge testament to our nursing school staff and their hours of work and dedication. The list could always go on.
|One of our sweet premies all grown up!|
I have learned over the last year that our “successes” and “losses” cannot be numbered on a tally board. Deaths vs Survival, Volunteers vs. None, Joy vs Fatigue—they are all an intricate plan that the Lord uses to refine us, grow us, and to show us and others who He is. There is no battle going forward where Satan is winning and the Lord is losing. Jesus has already vanquished sin and is the victor. Pray that we can begin to live and work in light of this beautiful picture of victory that is ever before us, the strokes of paint already laid on canvas. It is only with the choosing of the light colors alongside the dark, that makes all things visible.
As always, thank you for journeying with me. Thank you for your patience and your prayers. Please lift us up and we go into a season of both joyful and difficult anniversaries. You’re partnership in ministry here is never forgotten.
Monday, September 26, 2016
I realize that I haven't posted in 6 months and I apologize for that. Many of you faithfully pray for me and for the ministry here and read these posts as a way to stay connected. I think there was quite a transition time for me from all that took place and trying to create a new normal. My church asked me to write a piece for their website this month, so please follow the link below to read more.
Your prayers and love from afar are coveted and appreciated.
Grace and Peace
Tuesday, March 29, 2016
This Easter proved to be a somber yet beautiful reminder of the Lord’s ultimate hope and plan that He has put in motion long before our arrival here in Mango. We began with a sunrise service underneath a tree that could only be found in a Robert Frost poem, with branches stretching out exponentially to accommodate any size crowd and yet able to be conquered by any age child as they choose their preferred climbing height. It was the same tree under which we had Todd’s memorial service here. Our community house prayer/bible study groups were able to join together for a service and potluck in the afternoon—a two-hour plan that quickly stretched into four—typical for any gathering planned in most African cultures. In the evening, we gathered once again and were able to worship together, led by a guitar and violin that beautifully led use into communion. It was bitter-sweet to sing about the promise of the resurrection that went before us through Jesus Christ, and the promises that await those who place their trust in the Lord. A powerful promise to sing confidently, while pausing in disbelief that one of our own is experiencing this very promise this Easter, face to face with the the resurrected Christ.
So thankful that our friend didn’t have to wait one more Easter to have the promise fulfilled in his own walk with Jesus; So much wishing that our friend was here with us.
I walked outside behind our guest house after the service ended. I still find it difficult to socialize in groups. I stood with the chatter behind me, while gazing at the stars that are so very familiar to me in the Mango night sky. I looked up—not it awe, but in lament, feeling the loss as if it happened yesterday. I noticed the big dipper hanging low over the hospital, placed in the sky as if the contents were being completely emptied out over us. I thought, “it seems like a cup of suffering has been poured out on us in its entirety. What else could be in that cup pouring out over us?” I turned 180 degrees to avoid the sorrowful site. High in the night sky, situated directly over the town was the Southern Cross. It was if the Lord said, “I am bringing this people to myself. What if I can only do that through the cup of suffering that sits over the hospital?”
My immediate answer was, “No! We are supposed to have the cross over us while the suffering is in the town. That way, we can be a refuge! People come to us to find hope and the message of Christ! Suffering over there, hope and grace over here!”
But in His kindness, I felt the Lord saying to me, “I thought you were called to Christ-like? Didn’t I suffer so that you could come to know me? Didn’t I accept the plan of suffering through the cross in order that you could know me and be known by me? I’m over Mango and the hospital. Are you willing to continue to suffer so that I can do the work in Mango. I AM THE REFUGE, not the hospital.”
I stood facing that old, inviting tree. Before the hospital was built, on the rare occasions that I could come and visit Mango from the south, we would see a few patients on a bench underneath that tree. I wept for the plans I had envisioned for this place—not because they weren’t noble and hope-filled, but because there are parts of me who still want my plan over His. And I’m left with a question that still needs answering—do I mean it when I say “let they kingdom come, let Thy will be done…” ?
If any of you have ever read “The Problem of Pain” by C.S. Lewis followed by his later work “A Grief Observed” may understand the difference between theological knowledge and theological experience. It’s easy to write a blog about truth, it’s harder to walk into work each day accepting the situations before you as a perfect work of God’s unwavering plan of Hope.
But lovingly, God’s Word speaks to all things:
“For his sake I have suffered the loss of all things and count them as rubbish, in order that I may gain Christ and be found in him, not having a righteousness of my own that comes from the law, but that which comes through faith in Christ, the righteousness from God that depends on faith—that I may know him and the power of his resurrection, and may share in his sufferings, becoming like him in his death, that by any means possible I may attain the resurrection from the dead. Not that I have already obtained this or am already perfect, but I press on to make it my own, because Christ Jesus has made me his own. Brothers, I do not consider that I have made it my own. But one things I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus. Let those of us who are mature think this way, and if in anything you think otherwise, God will reveal that also to you. Only let us hold true to what we have attained.” Philippians 3:8-16
I cannot thank each of you enough for lifting this team up in your prayers, for lifting me up. I will be getting some time away to rest, reflect, pray and be ministered to starting this Friday. Please continue to pray as we “strain forward to what lies ahead” as a team and as a hospital family. The Lord’s hand of grace and mercy is still very much at work here and the enemy will not sit idly by. Please battle with us in prayer daily knowing that the battle is actually already won.
You are loved.
Monday, March 14, 2016
This God--his way is perfect; the word of the Lord proves true; he is a shield for all those who take refuge in him.-- Psalm 18:30
Merely ten days ago I wrote a blog about the grieving of a friend where I said, "the Lord had other plans." Little did I understand the extent of that statement and that we were actually in the middle, and not the end, of a story that continues to unfold today.
As many of you know already, Todd Dekryger was the Medical Director for this hospital as well as a talented surgical physican assistant who ran our surgery department here at the Hospital of Hope. He was the visionary, the motivator, and main recruitor for the team. But in the middle of Febuary, he became ill with symptoms consistent with malaria and rested at home over several days. He continued to struggle despite the treatment and was admitted to the hospital 1 week after he became ill. His testing for malaria was still significantly positive which spoke to us about the severity of the illness. His labs were also suspicious for Typhoid fever, which we began to treat as well. As many know the story, Todd continued to worsen and the decision was made to try and medivac him out-of-country to seek further supportive care and recovery. And although Todd was extremely ill when he boarded that small plane headed for Germany, I had no doubt in my mind that I would see him soon on Togo soil.
But this was not to be. Less than 24 hours after landing in Germany, Todd went to be with the Lord.
The story was over. Complications from severe malaria would not be overcome, but none of us were doubting that the Lord would somehow use Todd's death to still bring a message of Hope to the Togolese people--the message of how Christ had overcome death to save the world, to save the Togolese people.
But one week after boarding Todd onto that plane, Andrés, a volunteer nurse with Samaritan's Purse who had cared for Todd, developed a fever. As common diseases are common, Andrés treated his illness with malaria medications and tried to rest. Three days later, he came into the clinic because his fever never went away. By God's miraculous plan, Andres came into the hospital to get some IV fluids. The doctor who had cared for Todd happened to be passing off patient care to another doctor for the day, but happened to look up at the computer screen and saw Andres' lab results. Nothing short of dread came over her as the lab results that stared back at her were mirror images as those Todd had presented with.
What if Todd had something more?
That something more came to be diagnosed as Lassa fever--a viral hemorrhagic fever normally not found in Togo but instead endemic to Sierra Leone and Nigeria--countries that don't even touch Togo! By this time the suspicsion for Lassa fever was confirmed, Andres had already been isolated and infection prevention measures were taken. Samaritan's Purse was able to evacuate Andres to the United States where he remains hospitalized in order to recover. As it turns out, Nigeria was and is experiencing a large outbreak of Lassa fever that was able to reach our town, likely through a patient who wanted to seek care at the Hospital of Hope.
Many of you may be thinking, "This is still a horrible, tragic story." And in many ways it is. No one can deny the pain and void we feel every day because Todd is not here with us, leading the charge towards compassionate healthcare in the name of Christ.
But there may be something more.
If the inital patient, of whom we'll never be able to identify, had come into Togo and even our Hospital, and died here, we would've never known his true diagnosis. As sophisticated testing, such as Lassa testing, doesn't exisit here, the death would have tried to be assumed as liver failure, yellow fever, or just a severe bacterial infection. We would have continued to see patients and never associated that death with any other illness that may have developed in our healthcare workers here, or the community. Because we try to do as few labs as possible here, in order to keep things affordable for the Togolese, we wouldn't have seen daily labs each morning as we could with Todd. We would have never linked any labs results with each other.
What if the doctor that took care of Todd wasn't seated at that computer at that moment to see Andres' test results? Andres may have continued to get sicker and not had enough time to start treatment or get evacuated to the US.
Todd's illness and subsequent death made it possible for us, for Togo and for the world to be notified of a potential outbreak of a viral hemorrhagic fever in a country that was not felt to be at risk. Although many of us are on surveillance and verifying that we are not at risk, the story as it is unfolding, saved lives....many lives. Lives that this hospital was built to reach with the message of Christ.
The story seems like it should end there. But 3 days after Andrés left for the United States, and when we had already put an alert system in place due to the diganosis of Todd, a woman showed up to the hospital with a fever. Because she told us that she had come from Nigeria 3 days before, we put her in isolation immediately under surveillance for Lassa fever. Two days later, 2 of her children ,who we had been following daily, became symptomatic with fevers and were placed in isolation.
As I stood in that mother's room trying to explain to her the significance of Lassa fever and the tears were silently falling from here face, I said to her, "Did you know that the fact that you are here at he Hospital of Hope in Mango is a miracle?! I am so happy you are here with us."
I explained to her that it was only God's hand of mercy that after Todd's illness and death, Andrés visits to clinic and evacuation, along with her travel from Nigeria to our small town of Mango, we were able to identify her as a likely case of Lassa. If we never tested Todd's blood in Germany, if Andrés had not gotten ill, we would've never known or investigated further. Had this woman gone to any other clinc or hospital in Togo, they would have never placed her in isolation and she could have continued to spread the virus, unknowingly, to others. Because of each step, in God's perfect timing, this woman and her two children are at the only hospital in Togo that currently has the potential life saving medicine to work against Lassa fever. What are the chances that this family left Nigeria to come to Togo and ended up here...at this time.
Zero. That is, zero without a God whose hand of mercy stretches to the skies! I am confident that no other death could have sparked the response and timeline of discovering that Lassa fever was here in Togo. I am confident, that in no uncertain terms, Todd's death did make it possible for many others to keep theirs; others who have not yet heard the message of the Gospel; others who were either prevented from getting Lassa because of measures taken, or others who will now get a chance to be identified, cared for and treated.
No one who knew Todd has any doubt that he is face to face with The Savior Jesus Christ, the Son of Man who "did not come to be served, but to serve, and to give his life as a ransom for many" Matthew 20:28
And what further testimony can one give to show the love of Christ? "By this we may know that we are in him; whoever says he abides in Him must walk in the same way in which he walked." 1 John 2:5-6
But the final word cannot be about Todd or Andres.
Nor can it be about Togo or the Hospital of Hope.
"For by grace you have been saved, through faith. And this is not your own doing, it is the gift of God, not a result of works so that no one may boast." Ephesians 2:8-9
The story is the Story of Hope. And it continues on. It is the reason we are all here and we can't wait to see how Christ will use our weak, broken, mourning selves to carry on His message of joy, strength, and peace as we press forward.
Please continue to pray for Togo and that Lassa fever will not spread any further.
Please continue to pray for hope and healing our HOH team and the Dekryger family.
Please pray for the Morales family as they continue their journey of healing in the US.
Thursday, March 3, 2016
The battle we face here in Togo is often one of finding the peace and solitude among the peaks and valleys of the sovereignty of God--reconciling the unwavering truth of the The Gospel with the emotional waves one’s heart can ride upon during the storms.
I cry aloud to God,
aloud to God, and he will hear me.
In the day of my trouble I seek the Lord;
in the night my hand is stretched out without wearying
my soul refuses to be comforted.
When I remember God, I moan;
when I meditate, my spirit faints.
Our leader, our visionary, our friend Todd Dekryger lost his life to severe malaria and its complications on February 26 after arriving in Germany via an air medical evacuation. His amazing wife was by his side and wrote this amazing letter to us all in the short time that followed. There have been countless blog entries and articles honoring his life and death during the last week. Even as I type, I’m not exactly sure what is appropriate to share--what is there left to say…..
You hold my eyelids open;
I am so troubled that I cannot speak.
I consider the days of old, the years long ago.
I said, “Let me remember my song in the night;
let me meditate in my heart.”
Then my spirit made a diligent search;
“Will the Lord spurn forever, and never again be favorable?
Has his steadfast love forever ceased?
Are his promises at and end for all time?
Has God forgotten to be gracious?
Has he in anger shut up his compassion?”
Todd loved Peter, the disciple of Christ. Peter always said the wrong thing at the wrong time, yet he seemed to be the disciple that yearned to be closest to Christ despite his shortcomings. I believe that Todd was encouraged by that daily. The truth is that Todd wasn’t a superhero, as none of us are. Missionaries are often elevated up in Christian circles as being “larger than life” or spiritually superior. Todd would laugh out loud at that notion if he were still here. Todd was obedient to the Lord’s leading in coming to Togo, recruiting a massive team to help start a new hospital in the middle of a region lost without Christ. His invitations to join the Togo team were irresistible, as I experienced. After hearing Todd talk about Mango and the Hospital of Hope, you knew that the Lord was going to do great things whether or not you came...but you walked away not wanting to miss out on being a part of it.
There are too many things I could say about the week leading up to Todd’s death. The true miracles of how God made it possible to get Todd on the airplane to Germany. From the small rope attached to a semi-truck that had to pull our military ambulance 2 hours to reach the airplane after we had broken down on the side of the rode; the nurse that called a friend in Kara to meet us on the tarmac with 2 blood donation bags so that he could get transfused on the way to Germany, the fact that 2 of us bringing Todd to the airplane happened to have matching blood types…..
When the call came in the middle of the night that someone was coming to pick me up at a friend’s house and bring me to the hospital compound, I knew. But we rode in silence until we arrived at the Dekryger house. That dear missionary friend just turned around and embraced me. No words were necessary.
Then I said, “I will appeal to this,
to the years of the right hand of the Most High.”
The truth is that each day gets better. The truth is that each day is hard. Todd and I used to always laugh say, “If you die, I’ll kill you.” It was our way of letting each other know that we were in this for the long-haul. No matter who came and went, we were going to make sure that this hospital kept going. ISIS, Ebola, whatever. We were staying.
But the Lord had other plans. The Lord has other plans.
The nurse on the medevac plane was named Melanie, the name of Jennifer’s (Todd’s wife) mom. I thought it was such a sweet detail that the Lord orchestrated so that Jennifer could not feel so alone on that airplane ride. As we were loading Todd into the plane, I turned and noticed her eyes filled with tears. I knew she was overwhelmed by how sick Todd was. I knew she was overwhelmed by the thoughts that all of our hope was placed on her skills for the voyage to come. I took her by the shoulders and through my own tears said, “Thank you so very much. We can’t thank you enough. I know you are overwhelmed but it’s okay to feel weak. Christ’s strength is made perfect in our weaknesses. Our hope is in Him, not in you. It will be okay.”
She embraced me as if we were long-time friends unaware if we would see eachother again.
I will remember the deeds of the Lord;
yes, I will remember your wonders of old.
I will ponder all your work,
and meditate on your mighty deeds.
Your way, O God, is holy.
What god is great like our God?
You are the God who works wonders;
you have made known your might among the peoples.
There are reasons why, as doctors and nurses, we are not supposed to care for people that we know. But on the mission field, there is little choice. Many of us took care of Todd during his illness which we needed, in order that we were making objective decisions and not emotional ones. Despite Todd’s death I don’t look back and second guess his treatment here or the timing of our decision to send him to Germany. This isn’t our pride in thinking what good doctors we are, but instead due to the hundreds of folks praying for us every day--praying that the lies of the enemy do not discourage and incapacitate us. The Hospital of Hope will continue on because this work was the Lord’s from the beginning. Todd was faithful to the work, but more importantly he knew that the Lord used imperfect people to proclaim the perfect and complete work of the Cross. He knew that compassionate medical care and healing was only half of the story. He knew how to love people, how to forgive and how to be forgiven. He knew that he would see Jesus face to face, and his work would be done.
We miss you friend, but the work here is not done. The Lord is still calling his lost sheep here in Mango and beyond. By God’s grace, we continue what you helped start. By God’s grace, we will see you soon.
Wednesday, December 30, 2015
As far as I know, Pediatric Leukemia has never been treated in Togo. During my first two years in Togo, we did not venture into the possibility of treating this illness. The cost, the duration, the availability of medications--it all seemed impossible. In the year 2014, a Pediatric Oncology group from the University of Louisville heard about Togo and how children diagnosed with leukemia are sent home without the hope of treatment. Directly after my presentation, the Chief of the Heme/Onc department approached me to say, "This is unacceptable. What do we need to do?". After some headaches in finding the necessary medications and the long wait in finding a patient (many children with Leukemia are never appropriately diagnosed, or diagnosed and sent home, never making their way to us), a young 6 year old girl from our local town came into the hospital. She was diagnosed with High Risk ALL leukemia. Although our new protocol was in place, it wasn't what she needed for her advanced stages. Some adjustments were made to the protocol in order to try and give her a change at survival and treatment started. The entire hospital was learning together: New medications, safety protocols, Central Line education. The entire missionary team got involved with providing movies to watch, making her cards, bringing toys and games, learning to color. For about 5 weeks she was stuck in her room as she became the first child to be treated for leukemia in Togo. Meanwhile, our staff and chaplains tried to encourage her family through the hope of the Gospel.
Yesterday, we re-checked her Bone Marrow to determine if her first phase of chemotherapy was effective; it would determine whether she could go on with treatment or continue on with comfort measures only. We prayed and prayed that the bone marrow results would be clear, so that there would be no doubt as to which road to take. Under 5% meant that she could go on, the chemo worked. Over 20% meant that her response wasn't enough and giving more chemo wouldn't help her. The gray zone was what we prayed to avoid as it would be a battle of the unknown-- continue on with treatment knowing that our little resources might be used up without improving her survival, or stopping treatment when more could help. "Please Lord, be clear".
After a long wait, her bone marrow was complete: 26%. Our hearts were broken. Very broken. We had done more than we could and were sure that the Lord would "reward" us with our efforts and prayer for this sweet girl. We spoke with her parents and explained the results. We prayed with them and assured them that we would continue care for her so that she could have comfortable weeks at home, enjoying her brothers and sisters. We would see her each week and decide if she needs re-admittance to the hospital when the end comes.
You may be thinking, "that's why leukemia isn't treated in Togo."
I would say, "this is exactly why leukemia needs to be treated in Togo."
Every child deserves a chance of survival. In the cases where survival isn't possible, they deserve dignity in death and a hope that this world is not our home. Their families deserve to know what sickness has taken their child, and to make decisions as to how they are cared for until the Lord takes their child home. Nangeta will likely not make it to see spring, humanly speaking. But her and her family have now heard about the hope of Christ and that is never a waste.
One week before our results came in for Nangeta, a little 4 year-old boy, Martin, came to us with complaints consistent with a cancer diagnosis. After a few days it was evident that he, too, has leukemia. This time, a low risk ALL diagnosis--a very good survival rate. In some ways it seems to be the Lord's confirmation that we need to continue on with our efforts in making sure these children are given a chance at life. In some ways, it's daunting to start down this road so soon after the crushing blow.
Please pray for Nangeta and her family and we continue to minister to them during a difficult time.
Pray for Martin and his family and he begins a difficult journey towards hopeful healing. Pray for continued partnerships that make treatments like this possible for the children of Togo, and thank you to everyone who has already given of their time, prayer and finances to lift us up.
"For as the Heavens are higher than the Earth, so are My ways are higher than your ways, and my thoughts than your thoughts." Isaiah 55:9
To give directly towards helping children with cancer at the Hospital of Hope, go to www.abwe.org/give and use the account number 0763833-002.