A light in the shadows

Some months here in Togo are just rough.  Some months in life are just rough.  We seems to be under a shadow as we have had some incredibly difficult losses as a hospital over the last 4-5 weeks--many involving things that may have been all-together preventable.  I signed a death certificate every night last week.  This isn't a plea for pity as it is a recognition of reality. To paraphrase one of our other missionaries prayer letters she said- "I haven't been telling any good medical stories, but I can't seem to think of any….maybe it's because the sad stories just seem to overshadow the successful ones." And there comes a point, even in the most faithful of believers, when we stop and lift our tear-filled eyes to the heavens and say, "DON'T YOU SEE US LORD? Don't you see them?"

There is no greater place than the foreign mission field, to find out what your weaknesses are.  (and yes, the word weaknesses is definitely plural for all of us!) Not only will you, and everyone around you, see those weaknesses, but they will be magnified X 20 under the stress and culture shock of life.  My weakness magnified is pride.

As I had to explain to the mother of quadruplets that a second baby of hers would be leaving this world, all I could think about was that her sorrow was caused by my failure as a doctor. What did I miss?  What could I have done earlier? How did I let this happen?  As grief continues it evolves into anger, which is sometimes lands on God.  "Lord, how did YOU let this happen? Where were you?!" It's at this point when the Holy Spirit calls me by my nickname, Job.  Not because I am as faithful or have suffered anywhere near this Old Testament friend of God.  But because like Job, I feel like I want the chance to stand before a court and make my case before the Lord, in order to explain why these things shouldn't have happened.

If you've read the account, you know what response is coming from the Lord:

             Who is this that darkens counsel without wisdom?…

             Where were you when I laid the foundation of the earth

              Tell me, if you have understanding.

             Who determined its measurements—surely you know!

             Or who stretched the line upon it? 


             On what were its bases sunk,
    

             or who laid its cornerstone,

             when the morning stars sang together
    

             and all the sons of God shouted for joy?

            “Or who shut in the sea with doors
    

             when it burst out from the womb, 


             when I made clouds its garment
    

             and thick darkness its swaddling band,

             and prescribed limits for it
    

             and set bars and doors,

             and said, ‘Thus far shall you come, and no farther,
    

             and here shall your proud waves be stayed’?

             “Have you commanded the morning since your days began,
    

             and caused the dawn to know its place,

              that it might take hold of the skirts of the earth,
    

              and the wicked be shaken out of it?

              It is changed like clay under the seal,
    

              and its features stand out like a garment.

              From the wicked their light is withheld,
    

              and their uplifted arm is broken.

            “Have you entered into the springs of the sea,
    

             or walked in the recesses of the deep?

             Have the gates of death been revealed to you,
   

             or have you seen the gates of deep darkness?

             Have you comprehended the expanse of the earth?

             Declare, if you know all this.   

The Lord goes on for several more chapters to show Job his mightiness and omniscience.  Job's appropriate response:

             “I know that you can do all things,
              

              and that no purpose of yours can be thwarted.

              ‘Who is this that hides counsel without knowledge?’
              

              Therefore I have uttered what I did not understand,
              

              things too wonderful for me, which I did not know.




The Lord doesn't always respond to our sorrow this way, but for me it is often this way as the Lord shows me that He is indeed in all things and His sovereignty is sure.  He shows me that when the focus is my own failure, I am failing to recognize his glory and purpose.  I am also failing to recognize how he wants me to respond in a way that glorifies himself. As a result, there is nothing left to do but repent of thinking we know better.  Repent of believing that we are in control. And worship the ONE whose plan is above all things.  He never leaves us, nor forsakes us. He alone is righteous.  He alone is justice, love and mercy in perfect harmony.  He alone has conquered death and made eternal life with Him possible.  He alone makes beauty from ashes.  He is and always be the Savior, my Savior. 

There is a beauty and grace that is only to be found on the other side of suffering.  There is nothing more gut-wrenching that weeping alongside a mother over the loss of her child, nothing more humbling than holding a child while he takes his last earthly breath.  It is only the love of Christ that allows us to do these things and not be swallowed up in despair.  Because the answer for death here in Togo is not better medicine, a newer ventilator, or even more doctors--it's Hope, Hope in the One who conquered death so that it no longer reigns over us.  There can never be a true shadow over the hospital or over our lives when Christ is the center.  For Darkness can never overtake the light.  The light will always shine through, casting out darkness at all times.


"Lift up your eyes to the heavens, look at the earth beneath; the heavens will vanish like smoke, the earth will wear out like a garment and its inhabitants die like flies. But my salvation will last forever, my righteousness will never fail." Isaiah 52:6


Grace and Peace

kel

How much is ONE worth?

When I was still a medical student shadowing “real doctors” around, there was a moment when I realized that as medical professionals, we hold a strange and uncomfortable power.  I first realized it moments before my attending physician told a man that he had cancer.  From the time we walked into the room until the moment he spoke those deafening words, I realized that we held this piece of information that would change him forever.  I also realized that we had to decide the right moment to deliver this news.  I remember that I kept thinking, “Just give him one more minute, one more minute of blissful unawareness.”

Unfortunately, this same type of unwelcomed power exists here in Togo as well, although in a tragically different way.  One must understand that the majority of cases we see here in Togo are illnesses that we have in the US as well (aside from things like malaria and a few others).  There are two major differences though: the advanced stage at which they present to us, and the availability of treatment for those illnesses.  For example: we currently have several children that have come recently with advanced cancer.  Since we don’t have a pathology lab, we sent our biopsies to the US to be read.  This process takes at least two weeks.  In the mean time, we have to decide whether or not to start treatment.  If we start treatment, but the result comes back with a type of cancer that we cannot help, we have wasted several precious vials of chemotherapy that we may need for another child in the future.  If we do nothing, and wait for the result, the patient may not survive until then.  We must make a choice.  Treating one child may prove to be the death sentence for another, when there isn’t enough chemotherapy to go around.  What do you do?

I walked into OB clinic the other day and saw a woman on the table who appeared to be carrying triplets at term.  I quickly found out that she was only 17 weeks pregnant (with 3 other children at home) and all that abdominal swelling was ascites (fluid in the abdomen that accumulates usually when your liver no longer functions well).   Due to past experiences here I said, “She has Hepatitis B”—an illness rarely seen in the US thanks to vaccinations.  The diagnosis was confirmed later that day and I sat talking with our OB doctor about the horrors of Hepatitis B and the likelihood that she may not survive to carry this baby long enough to be born.  Later that night that same doctor called me and exclaimed, “There is a treatment for Hepatitis B!!  We might be able to help this woman live!”  I felt like a thief taking his hope away as I responded: “I know, but we don’t have it here.” Sigh.  As to not complete deflate him, I told him I would ask my mom (who works in the pharmacy purchasing world) about the price of the medication and if we could get it sent over for her.  By the next morning, I continued my felony robbery spree as I told him that the cost was $100/month (and she needed a years supply= $1200).  Sigh.  I was so very impressed by his commitment to helping this ONE woman.  This was not the first, or even 10^th time, I had seen this same case play out.  I sat there wondering, “After 22 months here, have I already lost sight of ONE?  This doctor knows there other woman out there with Hepatitis B.  He even knows that even if we somehow found the money to treat her, we couldn’t treat each case that came in.  But the following day, he told me that if some other labs looked promising, he was going to find a way to get her the medications.  I couldn’t help but cheer for him from within!  Even though I could hear so many arguments against it in my head.

Do you realize how many patients we could treat with that money?!

Do you know how many other Hepatitis B patients are going to expect this now?

Isn’t this a waste of resources, especially if she doesn’t get better after all?

Is it worth trying to save this ONE when we can’t save them all?

Although I truly believe that theses questions are valid, responsible and necessary, I don’t think they are the right ones when dealing with decision making around ONE patient that sits before us.

Our only true example to how to deal with this type of power/decision making/responsibility is to look at the only one who did it right, all the time—Jesus Christ.  Christ, throughout his ministry, ran his own missions hospital; or at the very least, a mobile medical clinic!  And upon looking at that ministry I notice two very important things: 1) He healed those whom God had brought to him. 2) He didn’t heal everyone in the crowd. 

Sometimes we must be sensitive to the Holy Spirit as to when he is asking us to act in an extraordinary way in a particular circumstance.  Perhaps, through the convictions of our OB doc, the Lord is asking us to “move mountains” on her behalf because of a plan He has that is bigger than you and I.  Of course, I’m no where near the physician that the Great Physician was and is.  But I am comforted by the fact that although he did have all the power in the world to heal all that came to him…he didn’t.  While it is beyond my finite comprehension to understand how and why he healed some and not others, I see that even in our ministry, we cannot do all things for all people.  But if we love the people that the Lord brings to us…love them in a way that goes beyond all understanding, and at the same time love the ONE who created all things—then and only then will we be able to use the small amount of power given to us, in a way that glorifies God and heals the nations.

Maybe the right questions are:

1) Have I spent time in prayer concerning the available resources and THIS patient’s specific care?

2) After some time in prayer, is the Holy Spirit asking me to go above and beyond my own and/or this hospital’s current resources?

3) What are the ramifications of NOT acting?

4)  Has the Lord already opened or closed doors in this situation that should be guiding my next steps?

I don’t know if we will be treating this woman or not….the jury is still out.  But if we do, it’s because the Lord brought her to us and moved in the heart of a specific doctor to say, “If we can’t treat the few cases that come to us, even if it costs that much, than what are we doing here?”  And I pray that the Lord’s name be glorified in all that we do, or don’t do.

Grace and Peace

Kel

The countdown begins...

HAPPY NEW YEAR!  (I guess I owe everyone a belated Merry Christmas as well!)  I'm not sure where December disappeared to.  I find that as my months left here in Togo become less and less, time seems to be accelerating towards that April deadline.  I have officially been here for 21 months and while it has gone so quickly, it's hard think of a time before Togo. Premature babies that were born the month I arrived are now walking and beginning to talk!

As most of you know, I will be leaving Tsiko in 4 months, at the end of April, to head back to the US.  I will have finished 2.5 years with Samaritan's Purse Post-Residency Program (which included language school) and will be stateside until I am able to raise the necessary support, and finish the required training for ABWE.  I spent 4 days in December up in Mango, my future home.  Visiting Mango is always somewhat poignant for me as I see people and ministry that I love, yet am not yet a part of.  That being said, I would never trade in the time I have spent here at HBB, as there is a beautiful ministry here of Christ's love being shared and lives being changed--including mine.

The amazing, hard-working Hospital of Hope construction crew now has the entire hospital under a roof and tiling has began in the clinic and OR.  Walking around the empty rooms you can almost see and hear the patients that will line the halls in 1 year's time.

medical wards

YAY ROOF!

Operating Rooms

I also got to visit some very dear Fulani friends of mine.  I met the wife over a year ago when another missionary brought here down to deliver her third child.  Although she had 2 living children, her two last deliveries ended in still-birth.  She spent over 3 weeks with us waiting to deliver and stayed about 2 weeks after.  Joyously for me, she stayed in my home with her healthy baby boy during the days that followed her hospital discharge.  We nicknamed her son "Petite mangue" (little Mango) and the name continues to this day.  He is now almost 13 months old and a cutie pie!  Please pray as their is a change I may be able to live with this family in a home they are currently building that is just down the street from the Hospital of Hope.  This would be an amazing opportunity for language learning (the language of Fulfulde) and a chance to really pour into their lives while sharing about the Good News.  I long to hear them singing His praises one day!



Also, this week the Northern team has been overwhelmingly humbled by a $250,000 grant that has been donated to the project, specifically for lab, X-ray, and solar power equipment!   This is a HUGE answer to prayer and an encouragement to know that we will be on track to open our doors with the necessary equipment on Jan 8, 2015!

Pediatrics Ward

Please keep in your prayers the continued needs of both HBB in the South and HOH in the North.  As some staff that help the South function, move north (especially Anesthesia Techs), this will leave holes in the South that need to be filled.  Both hospitals/fields are also in need of teachers, trained lab techs, and doctors, and well as church planters and chaplains.  God is working here in Togo and we are looking for folks who want to be a part of it!

I can't thank you all enough for your prayers and encouragement.  I am hopeful that I will finish out my last 4 months here in the South with enthusiasm and with attention to all the the Lord still has for me to accomplish for the Kingdom.  I am also hopeful that I will be able to return to Togo by Nov/Dec of 2014 to help open the Hospital of Hope.  I am trying to balance work & ministry while trying to complete my training requirements for ABWE so that nothing will delay my return.  I appreciate those who have stepped out in faith in supporting me already and I fully trust in the Lord's timing for my return to this country that I love and consider home.  Pray that while I have this huge goal for 2015, my eyes will stay fixed on what the Lord has for me here and now.

Praying that the Lord will show Himself to you in ways that expand your awe and wonder of His glory and grace.

kel

God's Grace

Many of you have been following the story of a 5 year-old Togolese girl named Grace either through this blog or perhaps facebook. I thought I'd take the time to expand on that story.

I first met Grace just a few months after I arrived in Togo.  Her father Komi, who helped out in our lab at HBB, brought her in one day looking very tired, sweaty, and weak.  Her heart was beating at 220 times a minute! (normal for her age would be around 80)  When the heart beats this fast, it actually doesn't have any time to fill up with blood and is essentially useless.  I knew she was suffering from SVT (Supraventricular Tachycardia)--a problem with the electrical system of the heart.  There are 3 treatments for this condition: a medication called Adenosine, a Vagal maneuver (ice pressed to the face or bearing down like you are going #2!), or shocking the heart.  I knew we had some Adenosine but it was expired.  I went to the doctor's office to get it and had them put an icepack on her face while waiting.  After about 5 doses of Adenosine and NO sign of the medication changing the rhythm in the least we were running out of options.  While debating whether to shock her heart, she had a seizure.  While the seizure wasn't good news, it actually put her heart into a normal rhythm.  After about 30 minutes she woke up smiling and giggled a bit and wanted to see her brother, Elizae.

After everything was calm, I flipped through her very thick medical chart and noticed that Grace had been diagnosed with this condition several years before, along with another structural heart problem.  An heart echo done years before showed that she had an open PDA, which is a vessel that is open in-utero so that blood can bypass the lungs (since the lungs are filled with fluid and don't "breathe"like normal).  After being born, this vessel closes.....or at least, is supposed to!

Grace went home after 2 days in the hospital and some treatment against malaria.  We increased the medication she had to take every day at home that tries to keep her heart from beating too fast.  The thoughts about exploring possible surgery in the US crossed my mind, but I wasn't ready to further explore things as I was still a novice in the Togo medical world.  I knew that I was dealing with a very special little girl, as I had never seen a child so filled with spontaneous joy.  There was no doubt that she carried with her the joy of the Lord everywhere she went.

A few months later she came in again.  Same symptoms, same worried look on her families faces.  After proving once again that Adenosine and ice packs weren't changing a thing, we shocked her heart. Immediately she opened her eyes wide and giggled, then reached out for her brother.  I didn't need to look at the monitor to know her heart was beating well again.

A few months passed and other admissions for her came.  Each time she also had malaria, which is rampant here in Togo, and likely served as a trigger for her SVT.  Each time we either shocked her heart back into rhythm or she would end up vomiting or seizing--none of which were long-term solutions!! Although I had been in contact concerning Grace's on-going care with my kind former colleagues at Kosair Children's Hospital, plans for searching out US surgical options were still put on hold as another employee's daughter was unexpectedly diagnosed with a Brain Tumor that needed an emergent operation.  (see blog posts "Berna part 1 and 2")  Thankfully through the experience with Bernadette, we make contact with an US based charitable organization called Healing the Children.  HTC helps find and facilitate finding surgical options for sick children all over the world (www.healingthechildren.org).

Near the beginning of 2013, we started more actively trying to find out our options for getting Grace overseas.  Even with the help of HTC, we kept running into roadblocks as many US hospitals are not taking as many surgical charity cases due to budgetary cutbacks.  Also, due to Grace's problem not only with structure, but the electricity component of her heart, her surgery required a special electrophysiology lab.  Through some contacts at Kosair we were able to find a willing and capable surgeon in India.  The cost of the surgery was still going to be around $8000 which I knew was VERY CHEAP in comparison to what actual cost was, but also a lot of money for both us at HBB and for the folks at HTC.  I also just didn't feel like that's where she was supposed to go, so we waited.

I knew the longer we waited, the more danger she was in. Her heart already showed changes of beating too fast on a daily basis; even on medications her heart rate was around 120.  Our friends at healing the children had some leads.  My home hospital Kosair was a possibility but had already committed to taking a young child from Pakistan.  They said if things fell through though, the might take Grace.  Of course, I couldn't pray for the Pakistani child's case to "fall through"as I was sure he needed help just as much as Grace did.  So we waited.

Meanwhile, Dr. Ed Fitzgerald, an adult cardio-thorasic surgeon from Indianapolis started advocated for Grace.  Dr. Ed has done an incredible amount of work to help us here at HBB, including frequent visits to come and serve here (even with C-sections!  How many CV surgeons can say they know how to do C-sections!)  With Dr. Ed's connections he started making phone calls all over the country.  We got word that a surgeon Texas Children's was willing to help us out, but it needed approval from the board.  I told Grace's dad that we were getting close and we needed to start getting identity papers for Grace.  (In Togo, you can't get a card that shows you are a citizen without going through some major paperwork and paying fees.  Only after you have that card can you start the passport process).

Komi, Grace's dad, working in our lab

 While waiting for word from Texas we got a call that said Grace's dad had a cardiac arrest in a classroom at the hospital.  Komi had been accepted into our training program to become a lab tech, and during morning devotions, he fell to the ground unconscious.  After hours of resuscitation Komi was still unconscious but his heart was beating.  As a hospital with no ventilator or bypass abilities, the changes that Komi was going to survive the night were slim to none.  But after 2 days, and in the early morning hours, Komi woke up, prayed aloud, and then said, "Where am I?"  After a week in the hospital the doctors felt that he had some sort of baseline arrhythmia (faulty electricity in his heart) and would need an internal defibrillator, which was not possible at HBB.  And although Komi's brain went without oxygen for likely at least 15 minutes, after about 2 weeks he was back in class.

Our friend Dr Ed went to work on trying to find hospitals that would take Grace and Komi!!  The possibility of Texas Children's was moving forward and we had some hopeful leads on Komi's chances as well.  Sadly, about 4 weeks later, Komi had another cardiac arrest while playing with his children and died a few hours after arriving at HBB.  The devastation overwhelmed everyone at the hospital as we all remained in a state of shock.  How could this happen to a joyful, Christ-serving, healthy young husband and father?  What was there to say to his young 29 year old wife and 2 young kids?  I pleaded with the Lord to open a door for Grace, so that her mom wouldn't have to bury another family member.

The e-mail came 3 days after Komi died.  Dr. Ed sent word that Riley Children's Hospital in his hometown of Indianapolis had accepted Grace and surgery would be on Dec 10th!!!!  PRAISE GOD!  The date of surgery was firm and couldn't be moved.  I knew we had A TON to get done, including passports and visas in only a month's time.  But while this news was a huge blessing, how could I ask Grace's mom to let her leave for the US, to get a surgery on her heart, when she hadn't yet buried her husband?  Grace's surgery wouldn't require opening her chest, or a long stay in the hospital, but it isn't without risk.  At Komi's funeral I watched as a family friend carried Grace on her back.  It was the only time in 2 years I had ever seen Grace without an infectious smile and laugh.  I knew her only chance was to go.

Grace with her mom and beloved brother, Elizae

Two days after the funeral I met with a somber mom and explained the situation.  She had no hesitation about Grace going and was extremely grateful to all involved at the life-saving chance this would give to her daughter.  We worked frantically at getting Grace her passport and visa.  Because of some red-tape and mis-steps, although we finally got both, we missed a deadline to apply for free flights for Grace to the US by 3 days.  But our God is bigger than deadlines, and the folks at American Airlines granted her the "Kids Miles"and even provided an escort to take her from Lomé to Indianapolis free of charge.  She will be staying with Dr. Ed and his family after being discharged from the hospital.  And as God would have it, a former Togo short-termer, Amie Bockstahler, is a nurse at Riley and will get to help out with Grace in the states and accompany her back all the way to Togo!

Bernadette (middle) with her mom, dad and sister Jeanette

My real Thanksgiving came 2 days early when we had a dinner with all the missionaries along with both the Pariko family (Berna's family) and Grace's family.  We ate a huge Togolese meal and Praised the Lord for His work in both these families lives.  The meal fell 2 weeks after the anniversary of Berna's return home and 2 weeks before Grace's trip to Indy.

I know there are sick children all over the world who die from lack of access to care like we have in the US.  We take care of those kids everyday here at HBB, and I spend many nights fighting against despair and questioning God's ways.  But then I see, that in His kindness and sovereignty, God chose to provide for these 2 children in a miraculous way.  We can ask, "Why not those others?" or we can choose to say, "Thank you for saving them." Isn't that what Thanksgiving is?  Recognizing that we deserve nothing and each thing God provides for us, from surgery to our very breath, is a gift from the Lord.

Yesterday, I tried to explain Thanksgiving to some Togolese friends of mine.  "It's a day when all American's spend with friends and family to give thanks." One Togo man said, "I don't understand, don't you give thanks to God everyday?!"
Amen my friend. Amen.

An aside.

This is NOT a normal blog for me…so beware !

But I feel that it is necessary to write, not only for me, but for many others out there who are like me (insert sarcastic comment: “Kelly, there is no one out there like you”)  haha. Ok, true.  Like me= Single missionary for this context.  Anyways……

I want to address a VERY COMMON conversation I have with people when they find out I am and will-be a long-term missionary in Africa.  It goes something like this:

Me: “Actually, I live in West Africa.”

Person: “ You LIVE there?!  Like forever?”

Me: “Well, at least until I feel the Lord asking me to live somewhere else”

Person: “Wow.  Well, are you married?”

Me: “Nope.”

Person: “Oh, so I guess you don’t want to get married.”

OR (version 2)

Person: “well how are you ever going to get married if you live in Africa?!

Insert my triple take, furrowed brows and look of confusion… followed by my sarcastic remark of:

“Oh yes of course, because there aren’t any men if Africa!” 

Now, this isn’t a blog about whether or not I want to ever get married; On the contrary.  It’s about obedience.   I believe that there is a passion given to each of us that comes from the Lord.  Not just the passion we have for the Lord, but a desire to use a particular talent, idea, or ability to further the kingdom of God.   I believe we can be most in line with the “mysterious will of God” when we honor the Lord through these things and give Him all the glory for what happens as a result.

So, when an opportunity comes to live out this God-given passion and gift, and it happens to take you to a difficult place, what is the correct response?  GO!!  When Jesus said to the disciples, “Come follow me,” they were expected to drop their fishing nets and follow him.  For the disciples to have responded, “I’ll be right there, I just need to finish building my house,”or “I’m coming!  I just want to do one more……”

I have met too many women (and men) who passionately want to reach the Nations for the Lord, who refuse to go because they won’t until they are married.  This mindset is troubling to me, and yet at the same time I have been there.   For me, at least, it came down to trust. 

Do I trust the Lord?

Do I trust Him to take care of me if I’m alone? 

Do I trust him to bring me a spouse anywhere I am in the world? 

Do I trust him if He NEVER brings me a spouse? 

The conversation at the beginning is a problem because it’s extremely discouraging for someone who is hoping to get married while trying to trust in the Lord by moving overseas as a single.  It’s also showing our small view of God to think he is limited by country borders or location when it comes to his sovereign will on who will be married.  It’s also assuming that everyone’s goal in life is to be married.

Maybe a better conversation would be:

Person: “Are you married?”

Me: “Nope.”

Person: “Well how can I help encourage you while you are overseas”

OR “Well tell me more about your ministry and the people you will be serving”

OR even “Are you nervous moving/living overseas as a single person?”

I think marriage is a amazing thing, created by God, to mirror Christ and His church.  And if two people desire to marry, and are passionately serving God in a way that is honoring to him, YAY!  But if getting married, or wanting to get married, ends up keeping you from fulfilling the passion for Serving Him that He has placed in your life, you need to ask yourself if you trust Him. 

In all honesty, I do hope to be married one day.  But, if I am single for the rest of my days, then I will trust that God had His purpose for it.  And maybe I was better able to serve Him as a single woman than I would have as a married one.   Because I KNOW I am in the right place.  And I’d rather die a single woman in Africa than live as a married woman anywhere else.   But thanks be to our God that those aren’t the only two choices! J

So if you know a single missionary, ask how you can encourage them or be a listener.  If you know a single person considering missions, don’t discourage them from going based on their marital status.   If you are already married, invite your single friends to hang out and not just to babysit your kids (although I don’t mind babysitting your kids, too!)  Let’s all find out how we can push one-another to be the active hands and feet of Jesus, and passionately serve Him in all the Nations!

How beautiful on the mountains....

This evening I found out that a boy named Bawa who has lived his life in Mango, Togo lost his lifelong battle with diabetes.  Upon meeting Bawa, even with my trained eyes, I would have guessed his age at about 12 at best.  The years of undiagnosed Type 1 diabetes stole his health, his vision and his manhood.  Although he was around 22, when he looked at me with his cataract-clouded eyes and wasted body, I couldn't help but want to carry him in my arms like a child.

A fellow missionary spent the last several months doing what she could to teach his widowed mother how to do insulin injections and adjust his diet.  They would use the little French mom knew, a small amount of Anafo, and a whole lot of hand motions to try and get all the ideas across.  Against all odds, Bawa actually started to gain some weight and carry some hope for the future.  His dream- to be able to go back to school.

When I was in Mango around 6 weeks ago, we heard that Bawa was taken to the local government hospital and hadn't woken up in days.  When we arrived, he had a blood sugar of 30 but the hospital didn't have any IV fluids that had sugar and he wasn't responsive enough to drink the juice we brought.     My fellow missionary who had been helping the family knew that we were in a losing battle.  We didn't have the resources, money or ability to care for Bawa, even if he got better this time.  We suggested that mom take him home and wrote the name of an antibiotic the family could try, if they could find the money.  We visited them in their 1 room, circular hut for the following few days.  His mom graciously and kindly tried to keep him clean when the small bits of porridge he ate seemed to exit as fast as it entered.  We prayed with him because we knew that our Father in Heaven could hear us, even if Bawa could not.  I left Mango prepared to get an email about his death in the following days.

But Bawa got better.  I knew there was nothing in that hut that could've saved him aside from God's grace.  We all praised the Lord--the Great Physician.

I got an email from my missionary friend yesterday that Bawa was once again in a coma and un-responsive, no matter what his sugar level was.  I thought "surely the Lord will save him again." But Bawa did not get better.  He will never return to school.

How are we, as believers in a loving God, supposed to respond to this?  I weep for Bawa, and the things he will never do.  I weep for myself, and the ever-present reminder that my profession is always a losing one, in the end.  I weep for the injustice of poverty and inequality of power.  And I weep for the unknown outcome of his eternal salvation.



Then the Lord said, "Before Abraham was, I AM". - John 8:58


"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

“I know that you can do all things; no purpose of yours can be thwarted.

You asked, ‘Who is this that obscures my plans without knowledge?’ Surely I spoke of things I did not understand, things too wonderful for me to know. "- Job 42:2-3


Our response: trust and humility in our Savior, the Creator and Redeemer of this universe. The fact is, God is weaving a tapestry that we can even begin to understand. Habakkuk complained and weeped over similar things, crying out to the Lord:


"How long, Lord, must I call for help,
 but you do not listen?
Or cry out to you, “Violence!”
but you do not save?
Why do you make me look at injustice?
Why do you tolerate wrongdoing?
Destruction and violence are before me;
there is strife, and conflict abounds.
Therefore the law is paralyzed,
and justice never prevails.
The wicked hem in the righteous,
so that justice is perverted."

The Lord's Response:

“Look at the nations and watch—
and be utterly amazed.
For I am going to do something in your days
that you would not believe,
even if you were told"


While I acknowledge that their is a specific context of this Biblical text, it clearly shows that God's response to our weeping and cries of injustice in this world is not "get over it!"or to ignore it. He is saying, "I know you can't SEE it, but I have a wondrous PLAN. One so amazing that you couldn't even comprehend it if I tried to show it to you."


Our response: Faith and Obedience to the One who sees and knows all things. Christ said, "GO and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the very end of the age.” (Matthew 18)


The Bawa's of this world need one thing. The same thing we ALL need. The saving grace and hope found in Jesus Christ. But "How then will they call on him in whom they have not believed? And how are they to believe in him of whom they have never heard? And how are they to hear without someone preaching? And how are they to preach unless they are sent? As it is written, “How beautiful are the feet of those who preach the good news!” (Romans 10:14-15)


You don't have to GO to Africa. You don't have to BAPTIZE in the Euprates. You don't have to make a DISCIPLE in Yemen. Have beautiful feet wherever God has placed them.


I know that Bawa heard the Good News, and that gives me Hope. Hope that he is in the arms of the Savior. Weep for those that have not yet heard, and go give them hope...today.

Praises and Prayers

At risk of losing some people by the end….this might be a long one!  Of course, those of you who know me also know that short conversations are not my gift, so this blog should make you feel like I’m standing right in front of you! J

First, I’ll update you on some work going on here at our Southern Hospital (HBB) where I’ve been working all this time.  One great story from this month is that this cutie pie named Yaywra just finished 6 rounds of chemotherapy and seems to be in remission!  She presented with a HUGE abdominal mass and ended up having an ovary removed that was probably about 10cm in diameter.  Unfortunately there was still a lot of cancer left behind.  Thanks to a hospital in Michigan who does our pathology for free, we were able to determine that she had Burkitt Lymphoma.  This type of lymphoma is endemic to Africa (and happened to be first reported by Dr. Burkitt who was a medical missionary in Uganda many years ago).  The good news is that it is usually VERY responsive to chemotherapy and kids have about a 75% of living cancer free if they make through all the treatments.  Unfortunately here in Togo, we start chemo on patients and then they never come back to finish treatments.  This is partly due to a misunderstanding of the chronic nature of cancer, and in part due to the financial constraints of families.  (In government hospitals, if you don’t have the money to pay for treatment or medications AHEAD of time, treatment isn’t given!  This means: if you child comes to the ED very sick and needing medications, the doctors write a prescription for IV fluids, antibiotics, etc. and you have to go to the pharmacy immediately to buy them.  If you don’t have the money, your child won’t get treated—no matter what!)

To attempt to alleviate this problem, I have started to tell families that they won’t have to pay anything until the end of all 6 cycles.  If they come for all 6, the hospital Pediatric Benevolence Fund pays about 50% (or more) of the total bill.  If they stop coming after just a few, I tell them that they will owe the hospital the total amount.  Of course, this is very motivating to families and we have been able to improve our rates of chemo follow-up!  A HUGE thank you to those who contribute to the Peds Benevolence Fund!  Because of you, these kids can get treatment!  Please pray that Yayrwa will continue to be cancer free!

We also have 2 premature infants right now—John and Image (pronounced the French way “ee-maj).  They were born 1 day apart both at 28 weeks, and weighing in at 900 grams (1 pound, 15.5 ounces!)  Image came into the world in very difficult circumstances.  Here mom came into our hospital with an enormous jaw tumor that was about to close off her airway.  Our Surgeons immediately placed a Trach-tube so that she could breath easier.  There wasn’t any chemo to offer her, nor could a surgery be done.  After a couple days, she was becoming obviously worse, and our doctors had to make the difficult choice to deliver the infant via C-section despite her prematurity.  Sadly, about 12 hours later, her mom passed away.  In subsequent days, Image was left at the hospital alone.  Her family had left and we were unsure if they would return.  But amazingly, after 4 days, her paternal grand-mother came and has been at her bedside ever since.  This grandma actually has 9 children of her own (all living), so Image has a HUGE family with many aunts and uncles that will care for her.  In the days that followed her mother’s death, we got word that her dad actually tried to commit suicide out of despair over the loss of his wife.  Thankfully, he was not successful and has since made several visits to the hospital to see his little girl fighting and growing!  For the last 2 weeks he has brought be a bushel of fresh vegetables from his village as a “thank you”!  God is using this little girl to give a new Hope to her dad, Praise the Lord!  I have also started a Bible study with the grandmother, which has been a great joy! Please pray for these little premies to grow well and tolerate feeding.  They are at about 22 days and reaching a month is an important milestone.  (If they make it past 1 month, they usually survive.)  Pray for their families as they have to stay at their bedsides 24/7 and it can be very exhausting!

Lastly (in patient care news).  This little girl's name is Grace and she is the daughter of one of our employees.  She is 5 years old and has a repairable heart condition.  We are currently working hard to get her to the US (or another country) for surgery.  She does well, but frequently comes down with malaria or other tropical illness that aggravates her condition severely.  Please pray with us as we work towards finding her the best place to go while trusting in God's timing for all things!

Meeting with new friends on a recent trip to Mango

I also wanted to say a word about my future plans here in Togo.  As many of you know, I recently joined ABWE in order to become a full-time missionary/Pediatrician here in Togo!  The need here is so very great, and I couldn’t imagine working anywhere else (and I’m trying to avoid ObamaCare! J)  While the need is very great here at our Southern Hospital, we also have a hospital that is currently under construction in the Northern part of the country, in a city called Mango.   This is a town of about 50,000 who are mostly Muslim and have VERY little access to healthcare.  Due to it’s location, the hospital will actually serve people from the surrounding countries as well—Ghana, Burkina Faso, and Benin!  We are praying that the construction will be done in the fall 2014, and that the doors will be ready to open on JANUARY 8, 2015!!  I have had to make a difficult choice in whether I will stay and serve here in the South, or go North. 

I said that I love pictures of older people because their faces tell
a story.  This Fulbe woman heard me and said, "I'm old, you
should take my picture."

                                                                                                     

When I first joined Samaritan’s Purse they asked me where I wanted to serve.  I thought back to my trip to Nigeria that year, and how oppressive it felt to drive through the Northern part of the country.  I realized that my heart was to serve in Muslim ministry somewhere in West Africa.  The town of Mango is within the famous “10/40 window”.  This is the area of the world that sits between 10 and 40 latitudes; within it lies the majority of the world’s poverty and unreached people groups.  What is an unreached people group?!  This is the term given to a group of people united in language and culture, who don’t even have access to hearing the Gospel.  It does not just refer to people groups who aren’t Christians, but instead to groups who have never even had the opportunity to hear about Christ.  One if these such groups is called the Fulbe (or Fulani), who are a Nomadic tribe found throughout West Africa comprised of about 20 million people spread over 19 countries and 99% Muslim.  This group of people is looked down upon by the tribes around them, as they are seen as refusing to conform to groups around them, living in “the bush” and maintaining century-long traditions.  Their lives as herdsmen are tightly tied to their cattle and being able to keep their cattle healthy is a huge opportunity for ministry (ANY VETS OUT THERE WANTING TO SERVE IN TOGO?!) Each smaller Fulbe tribe also carry their own traditions that can vary widely.  One of my good Fulani friends is part of a tribe that is not allowed to sing!!  I am praying for the day that I might hear her sing sweet words of Praise!

Pray for the over 300,000 people in Northern Togo who are considered a part of unreached people groups.  Pray for the hospitals in Togo and we continue to need people to serve both Northern and Southern ministries in Medical (Doctors, Nurses, Pharmacists, Lab Technicians, Xray/Echo techs), Administrative, Church Planting, IT, and Accounting!!  Pray that as I continue to raise support, I might be able to return to Togo by Jan 2015, in time for the opening of the hospital.

A HUGE THANK YOU to the 10 people who have already committed to monthly or yearly giving, as well as the 8 people who have given one-time gifts!  These have already put me at 40% of my needed support!  What a great encouragement this has been!  Many thanks to those of you who have committed to prayer, as this is truly how the Lord works, so that we may be a part of HIS ministry to the Togolese.

Grace and Peace-