RELIEF

 I'm not sure what can bring more universal comfort to people besides RELIEF. It's defined as the alleviation of pain, anxiety or distress.  Another definition said that it's a temporary break in a generally tense situation. For those of you who visit the blog regularly, I never want to give the impression that we are suffering 24/7, or that our days are always filled with sorrow. One missionary said today, "it's just that the peaks are so high, and the valleys so low." I'm not sure there is a better picture of life out here. Sometimes we are like the grass seeds underneath the desert sand, waiting for a drop of water so we can spring to life. And after the first rain of the season, you wake up to a field of green!

That's what the last few weeks have been like for our team, it seems. We had the amazing gift of a team from Springcreek Church (based in Wisconsin) come out for a visit. Among them were a pastor, a worship leader, Physical Therapist, 2 nurses, a doctor and a radiology technician. Somehow the Lord gifted them all with the ability to step into a place most of them had never been, and give rain! From the teaching to worship nights, to watching how 15 minutes with a Physical Therapist could change a Togolese woman's life--it was life giving.

Left lung filled with 3400 mL of blood (right). Xray after taking it all out! (left)

We've had some great cases of being able to provide relief for our patients as well. A young 20 year old Fulani man came in having been bit by a viper 2 weeks prior. He had sought treatment near his home but it wasn't quite enough and he progressively had trouble breathing. We obtained the Xray on the far right and found 3400mL of blood trapped between his lung and chest well (called a hemothorax)--that's as much as 14 cans of Coke....pressing in on his lung!! Needless to say, he was breathing much better afterwards and made a full recovery.



We are also full swing into rainy season, which unfortunately, is also malaria season. Sub-saharan Africa is home to 89% of all malaria cases and accounts for 91% of all malaria deaths. In the last year alone, the WHO estimates that there were 214 million cases of malaria with 438,000 deaths worldwide. Deaths from malaria here at HOH happen on a weekly, and sometimes daily basis and can bring a lot of discouragement. Most of these deaths are due to cerebral malaria--when the parasites enter the brain and cause seizures and swelling. The seizures can be very difficult to control and eventually the brain has enough. Children that do survive often suffer from some level of cerebral palsy afterwards. But sometimes we get to see kids in follow-up that recover with no long-term effects, like this cutie pie who was hospitalized for several days with cerebral malaria. Please continue to pray for many other children who are hospitalized at this very moment, fighting against this terrible illness. (our current number of in-patient children with severe malaria is 12!)

Coming in November I will also be getting some relief when I head out to Hong Kong on November 9-29th to visit a dear friend and her family! I have waited many years to go visit her in HK and I'm giddy with the idea that I'll be seeing her soon! Please pray for my travel and for the hospital staff who will have to fill in extra in my absence. Praise God for a Family doctor who will be coming to help during my 3 weeks away! Pray that she will not be overwhelmed and that the Lord would bless her and her family richly during their time here. 

Please pray that we can continue to provide relief here at the Hospital of Hope--physical, spiritual and emotional relief in times of suffering and great need.

36 hours

As you may know already, this past Tuesday evening brought us quite a surprise when a nurse came running to me to let me know that a woman had precipitously delivered a premature infant in the ward, and it was under her bed! I ran over to find an amniotic sac complete with the placenta exactly where she said. My immediate thought was "This baby is too premature, and dead." As I grabbed the still intact sac, the tiny life wiggled inside, to my shock and awe. I tore open the sac, (quite difficultly actually) and luckily a quick thinking nurse's aid had already tossed a clean blanket on the floor. A gasp for air and tiny cry that could only be heard within an 18 inch distance--this little girl was alive! Some appropriate panic followed, but soon enough our new little miracle was in an incubator and breathing on her own with the help of some oxygen.

Facebook posts went up about the crazy event and some of you may only be reading this blog now because of a "shared post". Many of you probably thought, "So how do you not know that someone is pregnant?!" To take you back to the beginning, this woman came in emergently around 5pm to our surgical clinic with a trapped umbilical hernia. Despite her reported 4 month pregnancy, and exam findings consistent with her report, she needed an operation now. The option was to pray that the stress of the operation didn't put her into labor. Durung the hours that followed, she complained of abdominal pain that was consistent with post-operative discomfort. Due to the timing of her surgery and shift changes, the nursing team was not yet aware of her pregnancy status. So, when she asked a nurses aid to help her off her bed in order to use the bedside commode, no one could anticipate what was coming next. I don't even think the mom herself knew what had happened since when I came running in to her, she was lying in her bed calmly, believing that "something had come out" from her surgery.

The little girl turned out to be about 27.5 weeks, just over the viable limit for us here. Her risk factors were many, but she looked strong and was obviously a fighter. We also had half the Facebook world praying by that time as the short story of her arrival travelled fast. How could she not do well? Surely the Lord was going to use this little one to show how strong and mighty He is! Surely even people thousands of miles away will be moved to see how amazing God is because this little miracle survived for years to come despite the odds!

About 36 hours later I got a call at home that our little girl suddenly wasn't breathing well, despite already being placed on CPAP-- the most airway support we can give here. I biked over to the hospital thinking that it might be a long day of creative airway support for her, but if we could make it over the next 24 hours, she would recover. She was awake and fiesty when I arrived, but her oxygen levels were low despite the nurses already doing everything right for her. The other pediatrician came and we looked at her brain with an ultrasound probe--left sided bleed--all too common in premies here and in the US. She would still grab my hand and open her eyes, but her struggle to breathe was evident. While another doctor spoke with the family, we made a last ditch effort to intubate her. Although we don't have ventilators I was hoping that a secure airway would help her and we could take turns bagging her for the da and evening to come.

But that was not to be.

The family took the news outwardly well which wasn't suprising. Families here often won't hold or name a child until they know he or she will survive. A long-standing cultural defense mechanism against the loss of too many babies for these women. I am still struggling with the loss and sorting through which are the effects of anger, embarrassment, humility, sorrow, and frustration.

Maybe I just wish she had a name.

In my selfishness of grief I think: what was 36 hours for? There will be no photo album filled with every passing hour of her short life, celebrated for years to come. No birthday remembrance every year on August 5th. Wouldn't it have been easier if that tiny, unbroken sac never jumped with signs of life? How did that glorify God?

I have never seen one of my Facebook posts get shared so many times as the other day. Some comments were promising to pray for her, some just marveling at the miracle if tiny life, and some giving me credit where none was due. But maybe some of you, for the first time, were considering the value of every life and acknowledging the power and wonder of God.  If that in the case, was her 36 hours of life worth it?

Was it worth it for God to allow that little life to touch you for 36 hours from 3000 miles away so that you might take a moment to recognize his power and might, his grace and kindness, his mercy and truth?

Out little girl does have a name, because God Himself knit her together in her mothers womb and numbered her days from the beginning of time. Maybe she will introduce herself to me when my life too comes to pass and the Lord takes me home. What a joyous day that will be.

Breathe

I will admit that sitting down to update anyone who reads this is often difficult.  My mind races through all the events over the past month and the days often slip through my memories like sifted sand. The only thoughts left are the rocks that were too big to make it through the tiny holes.  Unfortunately those rocks are often heavy losses and weighty decisions with poor outcomes—

The dad of the triplets arriving early in the morning to tell us that Baby B had a sudden seizure at home and died.

            A seemingly normal delivery that ended with parents going home childless.

            A toddler arriving urgently, still warm, but with no heart beat.

Life here takes an emotional toll and it often requires a conscious effort to push off the bottom of the pool and come up for air.

A few days ago I took a long, deep breath when I left the hospital work behind me to join three of our chaplains on a short trek to a rural village.  For the first time in the history of our ministry, we were getting the chance to show the Jesus film in the village of a particular tribe I hold close to my heart.  It seemed very surreal as our Land Rover bumped awkwardly over last years planting fields. The sunset view was speckled with lonely huts that seemed to only keep company for scattered cows and goats longing to find their shepherds.  After arriving, I couldn’t imagine that we would get a crowd for the showing of the movie since, besides the 3 adults and 4 children already present, there wasn’t another soul in sight and no hope as to where they might come from.

But after sundown, little by little more men, women and children arrived.  I started praying early that the generator would last long enough to finish the movie and not just leave Jesus dead on the cross! We prayed for calm winds (as our movie screen was not so sturdy and had to be tied to a tree with rope!), no rain, and open hearts.  For some of the people there, it wasn’t the first time to see the story. We had arrived at this moment because a man in the village had watched the film while being treated at our hospital and wanted us to show it to the rest of his village.  I couldn’t imagine what it was like to watch the book of Luke being played out for the first time ever; not knowing what was going to come next. How long I have taken the knowledge of the Bible for granted.

This people group is not one to react quickly.  They are deep thinkers, internal processors, and slow to show emotion. It may be months to years before we know if there was an impact to our evening in the village, but that is not for us to decide.

We drove away in the dark in awe of the sovereignty of God.  We did not go looking for this village.  (Even if we had tried, we could not have succeeded). Six months ago we didn’t even know this family existed. But the Lord orchestrated a man to be sick, seek care at our hospital, and so the story unfolds……

I return to the hospital but go to hide for a few moments. Time to sit alone and rest. Cry. Reflect. Breathe.

A recurring theme and reminder for me this month is that God sees us. He knows each and every village, every person, every language. God is not aloof or far from us. There is no game of hide and seek—he is always able to be found and we can never hide from Him or His love.  He hears us when we praise Him, and He bears our burdens when we don’t see His plan. I believe, help my unbelief.   

A sudden wave of relief and peace.  A faint smile and a weight lifted.

I am not here to save the world, Jesus already did.

Through the Cultural Looking Glass

It is often strange living far away from American culture and life because you soon realize that your daily interests soon become that of the country you are currently living in, not the country you came from.  But since I grew up with the ideal that you could never go to bed without having watched the news (certainly ingrained in me since my grandfather was the editor of NBC news Chicago), I still struggle through the slow internet connection and impatiently wait as the headlines and photos download on my computer each evening.

What has become more and more evident is how each culture defines freedom, rights, hatred, laws, social norms, and sin.  During the many weeks that racial motivated tensions were (and still are) mounting across the US, two tribes here in Mango began fighting, which resulted in many displaced families and destroyed property and livelihoods.  While all is calm at present, it seems that these two tribes have a long-standing mistrust of one-another and the embers are always ready to burn for anyone stoking the fire. 

When the Togolese hear about the fighting going on in the US centered around racial tension, they are often confused and find it ridiculous that black and whites would be fighting for no other base reason than color.  But when I compared our countries difficulties with the tribal warfare taking place, they would just smile half-way and say, “oh, that’s just the way it’s always been.”

Meanwhile, we’ve recently been having very difficult discussions about what to do when married girls between the ages of 12-16 come into the hospital for pre-natal care and obstetric care. They are often brought in by an uncle or a female relative. More often than not, they are the 2^nd, 3^rd, or 4^th wife of a man that is 20-30 years her senior.  These types of marriages are technically illegal, but culturally they happen every day and it’s the norm to complain, yet turn a blind eye as the “transaction” has already been completed and there’s nothing to be done.  Polygamy and child brides are the norm here, and regardless of approval, it is accepted by all.  Our American minds are immediate to call this rape, molestation, slavery, or just illegal at best.  But the husband did not steal the girl from a playground—her parents consented, a ceremony took place and they are living out in the open for all to see.  These aren’t dark alleys or private internet chat rooms.  While we, of course, do not agree with the practice, our first concern is figuring out how to make sure a 12 year old can deliver safely.

When the Togolese heard about the ruling of the Supreme Court yesterday, they were outraged. I didn’t make a comment either way, I just confirmed that it was, in fact, true. They were shocked and sad for us as Americans and for the world in general. We all just went about our day after the short blurb on American news realizing that our focus needed to be on the sick in front of us—a boy of 13 who came in as a near drowning after trying to save his brother (age 11) who had slipped while crossing the river. They were returning from a day of working in the fields.  I was secretly hoping that his comatose state could last as long as possible since the nightmare of finding out his brother was already dead and buried had not yet been realized.  When I later saw an American colleague we chatting briefly how cultural viewpoint changes everything. Togolese outrage on same-sex marriage while 12-year brides as 3^rd wives having babies, although is looked down upon, is accepted as a cultural norm.  We are thankful for the Word of God that speaks to all cultures at all points in time.

I rarely, if ever, discuss political agendas and Supreme Court decisions because I’m not in that culture currently, and I don’t find that it’s fruitful conversation.  The Roman Empire was steeped in deep sin and idolatry.  All of Jesus disciples were waiting for him to make a political stance and bring in a moral-political reign over the nation.  His lack of doing this did not mean that he agreed with what was going on, but instead, that he knew that men’s hearts cannot be changed by laws or by force.  The larger issue isn’t lawful rights or an outdated flag—although the issues themselves are valid discussions.

My job here in Togo is to help show that true happiness is found when we completely find our joy in the Glory of God. Issues of tribalism, child labor, and child brides are all worthy, and necessary, causes to fight against in the political arena, but no law can change men’s hearts.  John Piper said, “sin is the suicidal exchange of the glory of God for the broken cisterns of created things.” Even the 10 commandments were not made because the Lord expected us to be able to keep them all. They were given to us as a mirror, that we might see how far we had fallen from the holiness of God, and repent; That we may all continue to turn to God to find our completeness; that we may all seek God’s glory and not cisterns of broken creation.

I have very dear friends I love here in Togo that were child brides, that participate in child labor practices, that have multiple wives, that have undergone female circumcision and would do the same to their daughters, and the list goes on. We openly talk about these issues and how, I believe, God speaks to those issues. They know what I believe in and love me as well. There is no hate crime going on here. We talk about our ways of life, in love, and hide nothing in regards to who or how we worship. It’s not my job to even change someone’s heart—only the Holy Spirit of God will choose to do that. 

Please pray for Togo as we here pray for the United States.  Pray that both nations could be known as Nations that seek the Glory of the Lord.

From Death to Life

Ephesians 2:4-5

But God, being rich in mercy,

because of the great love with which he loved us,

even when we were dead in our trespasses, made us alive

together with Christ—by grace you have been saved

Practicing pediatrics in the US one can feel like we win all the time. Relatively few children die in the US and it’s a rarity and tragedy to find a mother who’s had to bury a child.  In Togo, it’s hard to find a mother who hasn’t buried a child, at least one.  In fact, many groups don’t give a name to their infants until the 8^th day, or sometimes until the first month, to avoid giving a name to a child that won’t survive.

I’m not sure how many of you have seen a dead person in real life. Not at a funeral when the dead are made to look alive somehow, but someone in the rawness of death. When it takes place in a hospital, it is often not beautiful nor peaceful. There is an ugliness to death that makes the witnesses feel violated and stolen from.  After a short time, it is also obvious. There is no confusion whether a person is dead or not.

For there is nothing in common between the dead and living.

The Word of God often describes us as dead. I think it’s a misunderstanding of this death that leads us to believe that we are better than we are, or that Christ’s love and sacrifice for us is somehow not as awesome as it is.  We believe that this death He speaks of is actually more like a peaceful, sleeping child whose mother comes in at night to tuck her child’s swooping curls behind her ear, afraid to wake her.  This leads us to think, “of course God has great love towards us, who wouldn’t want to swoop up a sleeping child in their arms—especially God!”

But the death that God speaks of is nothing like this. The actual idea is that of being pulled up out of a grave, a grave that we’ve been in for our entire lives.  This is the comparison made when Christ looks upon us, loves us anyway, and delivers us—

a rotting, cold, lifeless corpse. And what corpse could bring itself back to life?

One of my jobs here in Togo is to fight against physical death. It’s a losing battle. Even if I win today, I will always lose in the end.  No one has ever defeated death—except one.  And Christ makes us alive.  To fight for physical life without fighting for spiritual life is like pulling a corpse out of the grave and placing him in a tomb.  That’s why we’re here—to share a love that brings people from death to life. Not to force or manipulate, but to wait for God to move, for the Lord to pull people out of the grave and praise Him for it.

Isaiah 25:8

He will swallow up death forever;

 and the Lord God will wipe away tears from all faces

-K

PS: I appreciate everyone’s prayers for string of unfortunate events (broken computer, then phone, then computer, then internet, then a bout of malaria). If the Lord is trying to teach me something, I’m trying to listen. And if Satan is trying to discourage me, I’m not, which I’m sure is thanks to all of your prayers. This ministry could not continue without the sustaining prayers of all of you. I’m deeply grateful for all of you.

Rejoice with those who Rejoice

I saw this sweet little boy 4 weeks ago when our surgeon, Todd Dekryger, called me in to his clinic room. As soon as we looked at him we new that he most likely had Burkitt Lymphoma--a type of cancer that is endemic to Africa for reasons that aren't fully understood. The cancer is named after Dr. Denis Parsons Burkitt who was a medical missionary in Kampala, Uganda and first described the tumors extensively as a problem throughout the country.
He had been brought it by his older brother who explained that this mass had appeared over the course of a month, but they had visited fettish healers prior to coming to the Hospital of Hope.

He was admitted to the hospital the next day for a biopsy and some blood work. Thanks to the wonderful Pathology Department at St. Joseph's Hospital in Ann Arbor, MI we were able to send off the biopsy to be diagnosed at no charge.  But since the biopsy has to be hand-carried back to the states by a visitor leaving HOH, chemotherapy treatment is started despite not being 100% sure of the diagnosis. At the beginning of treatment we have a very serious discussion with the family. The child must stay for about a week the first time, then return once a week for four weeks to continue treatment. After one month, treatments are spread out to every 3 weeks, including a 2 day hospital stay each time. The course of treatment can be exhausting and is very expensive. Because there is always a chance that the family won't return after a few weeks, I explain to them that if they are faithful to their appointments, the hospital will share the cost of their treatment. But if they stop coming early, the family will be responsible for the entire cost. I realize this might sound very harsh to some, but it can be very difficult to come by these medications, and if a patient stops mid-treatment, all has been wasted and can't be used for a future patient.

Thankfully, the tumor began to respond to treatment in a matter of DAYS and the family could witness the healing of their son and brother before their eyes. He has been faithful to his last 3 visits and today when he arrived, he was completely transformed to his old self! (So much so that I had no idea who he was when a nurse notified me he was here for treatment!)

This cutie is actually only 1 of 5 children going through chemotherapy treatment here at HOH. These treatments can only be successful when we are able to support families (in-part) and when the hospital is able to purchase needed chemotherapy drugs. If you are interested in directly helping with either patient care, or the purchase of needed medications, thankfully there are two accounts set up through ABWE exactly for these reasons!

The Lord is doing mighty things here in Mango, and this is just one of many. Although each week we often experience the searing pain of loss, we are also blessed to experience the sweet joy of healing!
We could not continue this work without your faithful prayers and support, and we thank the Lord for YOU daily!

www.abwe.org/give
Pediatric Patient Care Fund: 0763833-001
Chemotherapy Fund: 0763833-002

Africa Has Candy

 

Have you ever gone on a missions trip? Have you made your packing list weeks in advance and made sure to leave room for things like candy to hand out to children you pass on the street or in villages? I would argue that almost all of us who have traveled to the developing world have done just that. I know I have.

But I'll let you in on a little secret. Africa has candy. A lot of it. In fact, if you go into a small boutique here in Mango, you can find that at least one-third of what they are selling is some type of candy. Ginger candy, chewing gum, mints, fruit-flavored hard candy, cookies....the list goes on! The funny part is that most of the children prefer this candy to the things we bring over from the US. Our American candy is often too sweet, or have flavors or textures they are familiar with at all (and don't want to be for that matter!)

Unfortunately this phenomenon has led even the smallest village children to immediately start demanding candy from any Westerner that happens to walk by.  So why do they do this if they already have access to all the candy they would ever want or need? Why are they asking us for candy, when they may not even like it as much as the candy sold for 1 cent down the street? I believe it's because when we give them something, even something they already have, they assume it's better. It must be better since it's from America, right? They start to long for something they never thought they were missing, and weren't missing in fact.

We have a very sweet American radiology tech named Michaelle here at HOH. I love her for so many reasons, but what I think is the most amazing is that she hands out candy to kids after their Xrays. And while this seems to undermine my previous 3 paragraphs, it actually doesn't, because she hands out small pieces of candy that she buys from a local store here in Mango. The candy is familiar and accessible, because of course, who doesn't want a piece of candy after they stayed real still for their X-ray?!

All this is to say that Togo, and many parts of Africa, have their own candy. Meaning, they aren't missing something just because they don't have exactly what we have. If I were to ever write a book at the end of my experiences overseas, I would title it, "Africa has candy", and write about all the incredible resources, physical and non-physical, that these countries already possess.  Kids are kids, no matter where they are in the world. They have their own ideals of what is fun, silly, and sweet! Of course, this idea is not just about candy, but I think you get the idea. An idea that came to me while I was sitting on my porch one day and was having a wonderful time with the children that live at my house. As they were trying to take some" selfies" I just kept thinking about how children in the US would be acting the same way--making faces, laughing, comparing photos with one another. We laughed until our bellies hurt. While there are things in life they are in need of, I don't ever want them to think that they are missing out on something.

There is MUCH to say about the hospital and things going on, but I will save that for a post next week. I thought I'd give you a glimpse into my life away from the hospital and at my home where I share a living space with  6-12 Fulani adult woman and children and any given time. (99% of them are NOT French speaking, but only speak Fulfulde, which I am trying my best to learn rapidly!) They have become my Togo family. I'm very thankful that the Lord has allowed me to share life with this extended family, and that despite the peaks and valleys of emotion at the hospital, there is always joy waiting for me at home.